Archives of Orthopaedic and Trauma Surgery

, Volume 125, Issue 5, pp 342–347

Role of parenteral iron in the management of anaemia in the elderly patient undergoing displaced subcapital hip fracture repair: preliminary data

  • Jorge Cuenca
  • José Antonio García-Erce
  • Angel A. Martínez
  • Víctor M. Solano
  • Juan Molina
  • Manuel Muñoz
Original Article

DOI: 10.1007/s00402-005-0809-3

Cite this article as:
Cuenca, J., García-Erce, J.A., Martínez, A.A. et al. Arch Orthop Trauma Surg (2005) 125: 342. doi:10.1007/s00402-005-0809-3

Abstract

Introduction

An important percentage of patients affected by hip fracture require the administration of allogenic blood transfusion (ABT) to avoid the risks of perioperative acute anaemia. However, concerns about ABT risks have led to the search for alternatives, especially in elective orthopaedic surgery.

Materials and methods

We have prospectively investigated the effect of preoperative intravenous 200–300 mg (group 2; n=20) iron sucrose on ABT requirements and postoperative morbid-mortality in patients undergoing surgery for displaced subcapital hip fracture (DSHF) repair. A previous series of 57 DSHF patients served as the control group (group 1). All patients were older than 65 years, were operated on the 3rd day after admission to the hospital, by the same medical team, and using the same implant. Age, gender, ASA classification, surgical procedure, perioperative haemoglobin, requirements for ABT, postoperative infection, length of hospital stay (LOS) and 30-day mortality rate were examined.

Results

No adverse reactions to the iron administration were observed. The iron group had a lower transfusion rate (15% vs 36.8%), lower transfusion index (0.26 vs 0.77 units per patient), lower 30d mortality rate (0 vs 19.3%), shorter LOS (11.9 vs 14.1 days), as well as a trend to a lower postoperative infection rate (15% vs 33%).

Conclusion

Preoperative parenteral iron administration could be a safe and effective way to reduce the ABT requirements in DSHF patients. This reduction in the ABT requirements is accompanied by a reduction in the morbid-mortality rate and LOS. A large, randomised, controlled trial to confirm these results is warranted.

Keywords

Subcapital hip fracture Iron sucrose Allogeneic transfusion Length of hospital stay Mortality 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Jorge Cuenca
    • 1
  • José Antonio García-Erce
    • 2
  • Angel A. Martínez
    • 1
  • Víctor M. Solano
    • 3
  • Juan Molina
    • 4
  • Manuel Muñoz
    • 5
  1. 1.Department of Orthopaedic and Trauma Surgery‘Miguel Servet’ University HospitalZaragozaSpain
  2. 2.Department of Haematogy and Haemotherapy‘Miguel Servet’ University HospitalZaragozaSpain
  3. 3.Department of Preventive Medicine‘Miguel Servet’ University HospitalZaragozaSpain
  4. 4.Department of Orthopaedic and Trauma SurgeryHospital of BarbastroHuescaSpain
  5. 5.GIEMSA, School of MedicineUniversity of Málaga, Campus de TeatinosMálagaSpain

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