[Relationship between allogeneic blood transfusion, iron deficiency and nosocomial infection in patients with hip fracture].

BACKGROUND AND OBJECTIVE

To know the frequency of nosocomial infection (NI) in surgical hip fracture patients and to analyze the risk factors that favor the NI development, especially its relationship with allogeneic blood transfusion (ABT) and intravenous iron administration.

PATIENTS AND METHOD

Unicenter prospective observational study of all hip fracture surgery patients during 8 months. The demographic, clinical and hematimetric differences between the infected and not infected patients were described. A logistic regression analysis was made to know the variables that predicted NI development.

RESULTS

26.1% of all 286 patients studied developed NI, urinary infection being the most frequent. The existence of lower hemoglobin or ferritin levels at admission, as well as increased values in ASA (American Society of Anesthesiologists) scale were associated with a greater risk of NI development. ABT and the number of red blood cell units transfused were also associated with an increase of the NI risk. No relationship between intravenous iron administration and NI was found.

CONCLUSIONS

Lower haemoglobin and ferritin levels and ABT are associated with an increasing NI risk in surgical hip fracture patients. Thus, in order to decrease the frequency of NI in surgical patients, the development of blood saving protocols including intravenous iron administration would be recommendable.