Aims: Anaemia is common in older hip fracture patients and is known to worsen outcomes. The study aimed to determine if there is an association between untreated moderate pre-operative anaemia when compared to mild or no preoperative anaemia with the specific patient outcome of hospital length of stay (LOS) during the acute care period.
Methods: A retrospective, observational study was conducted, at a tertiary teaching hospital for patients aged 65 years and older who underwent emergency hip fracture surgery between November 2022 to October 2023.Patient demographics, preoperative haemoglobin level, co morbidities, surgical and post-surgical variables were collected. Patients who received blood transfusion during admission were excluded. Patients were categorised into two groups: mild/no anaemia (Haemoglobin levels ≥ 11 g/dl) and moderate preoperative anaemia (Haemoglobin : 8-10.9 g/dl). Multiple linear regression was used to assess the association between preoperative moderate anaemia and hospital LOS, controlling for confounders.
Results: About 148 patients were enrolled, with a mean age of 83 years (63% female). Around 42 (28.3%) had moderate anaemia. No significant association was found between preoperative moderate anaemia and hospital LOS (p=0.583, β: 0.857 on univariate analysis). Multivariate analysis adjusting for age, sex, comorbidities, surgery type and fracture type also showed no association.
Conclusion: In older patients undergoing emergency hip surgery, untreated moderate preoperative anaemia was not associated with increased LOS. There was also no statistical difference in post-operative complications. Further research is needed to explore the impact of severe anaemia (Haemoglobin <8g /dl).