Related Experiment Videos
Associations between Red Blood Cell Transfusions and Health-Related Outcomes in Older Adults with Hip Fractures: A
Carmelinda Ruggiero1, Leonardo J Uribe-Cavero2, Fabian A Chavez-Ecos2
1Section of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Background:
Hip fractures (HFs) are increasingly common in aging populations and often require surgical intervention, leading to significant blood loss from both the injury and the procedure, increasing the need for red blood cell (RBC) transfusions. Despite evidence from randomized controlled trials, indicating the risks associated with RBC transfusions, they remain a standard treatment for patients with HF. This systematic review and meta-analysis aimed to evaluate the impact of RBC transfusions on mortality and 30 d clinical outcomes.
Methods:
We conducted a systematic review of observational and experimental studies on RBC transfusions in adults undergoing HP surgery. Without language restrictions, we searched PubMed, Scopus, Web of Science, and EMBASE up to September 1, 2024. Effect sizes for continuous variables are reported as means with 95% confidence intervals (CIs), whereas dichotomous variables are reported as risk ratios with 95% CIs. A random-effects model was used for the analysis.
Results:
We included 26 studies involving 59,627 patients with HF, 42% of whom received RBC transfusions. Transfusion rates varied widely by country. Women and older patients with HF received fewer RCB transfusions than men and those under 90 years old. RBC transfusions were associated with increased 30 d mortality, 30 d skin infections, and pneumonia, with a tendency toward higher 1 year mortality.
Conclusions:
RBC transfusions in patients with HF are associated with increased risks of 30 d mortality, 30 d skin infections, and pneumonia. Careful consideration is essential when administering transfusions to this vulnerable population.
Related Concept Videos
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...