Hip fragility fractures: Anaemia, calcium and vitamin D supplementation

To assess the burden of anaemia and osteoporosis in hip fracture patients, to determine the rate of blood transfusion per-operatively, to assess the use of calcium and vitamin D supplements and the use of anti-osteoporotic medications postoperatively.

A retrospective study was conducted at Aga Khan University and Hospital (AKUH) between June 2009 and May 2011, and comprised record of patients treated for intertrochanteric and femur neck fractures. Patients with associated pathological, open or long bone fractures were excluded. The main study outcome measures were the use of pre-operative and post-operative calcium, vitamin D, bisphosphonates and management of anaemia pre- and post-operatively. Demographic data was also collected including age, gender, and co-morbids. Statistical analysis was performed using SPSS 19.

Of the 129 patients, 65(50.4%) were women. The overall mean age was 67.2±15.5 years. Mean pre-operative haemoglobin level was 12.3±1.5 gm/dl and 39(30%) patients were anaemic, while post-operative haemoglobin was 10.2±1.71 with 90(70%) anaemic patients, but only 14(10.9%) patients received per-operative blood transfusion. Pre-operative and post-operative vitamin D supplementation was advised in 3(2.3%) and 18(14%) patients respectively, whereas pre-operative and post-operative bisphosphonate supplementation was advised in 3(2.3%) and 1(0.8%) patients.

There is a strong need to pay attention to the management of peri-operative anaemia and calcium, vitamin D and bisphosphonate supplementation in the discharge medications of patients with hip fragility fractures.