Li Pei-Pei, Zhang Ziruo, Hu Jing, Zhi Hong, Xie Ping, Jiao Xin, Chen Dan, Wen Lian
Sports Medicine Diagnosis and Treatment Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an City, Shaanxi Province, China.
School of Medicine, Yan'an University, Yan'an City, Shaanxi Province, China.
Int Orthop. 2025 Jun;49(6):1483-1491. doi: 10.1007/s00264-025-06521-4. Epub 2025 Apr 9.
This research was designed to explore the incidence of anaemia before surgery and the rate of mortality one year after surgery for femoral neck fractures in older adults. It also investigated whether anaemia prior to surgery influences the likelihood of mortality within one year after the procedure.
A retrospective cohort analysis was undertaken at Honghui Hospital, a tertiary academic medical institution affiliated with Xi'an Jiaotong University in China. This investigation included elderly individuals who underwent surgery for femoral neck fractures within the year spanning from January to December 2021. The research team gathered data encompassing demographic details, levels of haemoglobin prior to surgery, existing comorbid conditions, and mortality statistics after one year.
In this retrospective study, 994 patients were analyzed, with 84 reported fatalities. The incidence of anaemia in this group was 71.1%, affecting 707 individuals. Of these, 486 (48.8%) had mild anaemia, and 221 (22.2%) exhibited moderate to severe anaemia. Independent factors correlating with heightened one-year mortality risk included operative blood transfusions (odds ratio [OR] = 1.8, p = 0.0327), coronary artery disease presence (OR = 1.85, p = 0.0077), and moderate to severe anaemia (OR = 3.18, p = 0.0006). In contrast, higher body mass index (OR = 0.8, p < 0.0001) and red blood cell count (OR = 0.6, p = 0.0253) were linked to reduced one-year mortality risk. Multivariate logistic regression analyses underscored the independent association of moderate to severe anaemia with increased one-year mortality risk, with varying ORs across models: non-adjusted OR at 3.18 (p = 0.0006), Adjust I model OR at 3.08 (p = 0.0191), and Adjust II model OR at 2.96 (p = 0.0278).
At Honghui Hospital, affiliated with Xi'an Jiaotong University in China, anemia has been identified as a common condition among elderly patients undergoing surgery for femoral neck fractures, and it significantly contributes to an elevated risk of mortality within one year post-surgery. It is advisable to implement interventions aimed at managing anaemia before surgery, which should include setting haemoglobin thresholds that are not specific to any gender for its diagnosis.
本研究旨在探讨老年人股骨颈骨折术前贫血的发生率以及术后一年的死亡率。同时调查术前贫血是否会影响术后一年内死亡的可能性。
在中国西安交通大学附属的三级学术医疗机构红会医院进行了一项回顾性队列分析。该调查纳入了2021年1月至12月期间接受股骨颈骨折手术的老年人。研究团队收集了包括人口统计学细节、术前血红蛋白水平、现有合并症以及一年后的死亡率统计数据。
在这项回顾性研究中，分析了994例患者，其中84例死亡。该组贫血发生率为71.1%，涉及707人。其中，486例（48.8%）为轻度贫血，221例（22.2%）为中度至重度贫血。与一年死亡率风险增加相关的独立因素包括术中输血（比值比[OR]=1.8，p=0.0327）、存在冠状动脉疾病（OR=1.85，p=0.0077）以及中度至重度贫血（OR=3.18，p=0.0006）。相比之下，较高的体重指数（OR=0.8，p<0.0001）和红细胞计数（OR=0.6，p=0.0253）与一年死亡率风险降低相关。多因素逻辑回归分析强调了中度至重度贫血与一年死亡率风险增加之间的独立关联，不同模型的OR值有所不同：未调整的OR为3.18（p=0.0006），调整I模型的OR为3.08（p=0.0191），调整II模型的OR为2.96（p=0.0278）。
在中国西安交通大学附属的红会医院，贫血已被确定为接受股骨颈骨折手术的老年患者中的常见情况，并且它显著增加了术后一年内的死亡风险。建议在术前实施旨在管理贫血的干预措施，其中应包括设定不针对任何性别的血红蛋白诊断阈值。
