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Praetorius K, Madsen CM, Abrahamsen B, et al. Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture. Geriatr Orthop Surg Rehabil. 2016;7(3):115-20doi: 10.1177/2151458516647989.
Praetorius, K., Madsen, C. M., Abrahamsen, B., Jørgensen, H. L., Lauritzen, J. B., & Laulund, A. S. (2016). Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture. Geriatric orthopaedic surgery & rehabilitation, 7(3), 115-20. https://doi.org/10.1177/2151458516647989
Praetorius, Katrine, et al. "Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture." Geriatric orthopaedic surgery & rehabilitation vol. 7,3 (2016): 115-20. doi: https://doi.org/10.1177/2151458516647989
Praetorius K, Madsen CM, Abrahamsen B, Jørgensen HL, Lauritzen JB, Laulund AS. Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture. Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):115-20. doi: 10.1177/2151458516647989. Epub 2016 May 17. PMID: 27551568; PMCID: PMC4976734.
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Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):115-20. doi: 10.1177/2151458516647989. Epub 2016 May 17.

Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture.

Geriatric orthopaedic surgery & rehabilitation

Katrine Praetorius, Christian M Madsen, Bo Abrahamsen, Henrik L Jørgensen, Jes B Lauritzen, Anne Sofie B Laulund

Affiliations

  1. Department of Orthopaedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
  2. OPEN-Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
  3. Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.

PMID: 27551568 PMCID: PMC4976734 DOI: 10.1177/2151458516647989

Abstract

INTRODUCTION: Previous smaller studies suggest that anemia is a risk factor for mortality in patients with hip fracture. The purpose of this investigation was to assess the correlation between hemoglobin at admission with 30-day mortality following a hip fracture in a large-scale study.

PATIENTS AND METHODS: From January 1996 to December 2012, all patients with hip fracture (>60 years of age) admitted to Bispebjerg Hospital, Copenhagen, were identified from a local hip fracture database. We excluded conservatively treated patients and patients who died preoperatively.

RESULTS: Seven thousand four hundred twenty-one consecutive patients with hip fracture were identified. Of those 7319 had a hemoglobin measurement on admission and were thus eligible for further analysis. Mean hemoglobin for patients alive at 30 days was 7.6 (standard deviation [SD]: 1.0) and for deceased patients 7.4 (SD: 1.1), P < .0001. Mean age was 82.6 years (SD: 8.5), and 76.5% of the population were female (Nfemales = 5600). The 30-day mortality decreases for every increase in hemoglobin of 1.0 mmol/L in a univariate analysis (P < .0001). The hazard ratio (HR) with 95% confidence interval (CI) for 30-day mortality in patients with anemia (<7.3 mmol/L for females and <8.3 mmol/L for males; Nanemic = 3235) was 1.66 (CI: 1.43-1.91, P < .0001). Adjusting for age, type of fracture, gender, and comorbidities (Charlson score) slightly attenuated the risk estimate (HR: 1.21, CI: 1.03-1.41, P = .02).

CONCLUSION: This study demonstrates increased 30-day mortality in patients with low hemoglobin at admission, even after adjusting for comorbidities.

Keywords: anemia; hemoglobin; hip fractures; mortality

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