OTA 2012 Posters

Scientific Poster #4 Hip/Femur OTA-2012

The Effects of “Old” Red Blood Cell Transfusion on Mortality and Morbidity in Elderly Patients With Hip Fractures

Assaf Kadar, MD; Ofir Chechik, MD; Gabby Meghiddo, MD; Amir Sternheim, MD;
Department of Orthopedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine,
Tel Aviv University, Ramat Aviv, Israel

Background/Purpose: Elderly patients admitted with hip fractures often receive allogenic blood transfusion (ABT) in the perioperative period. ABTs with a longer storage time have been shown to have a negative impact on mortality in patients undergoing cardiac surgery. We examined the effect of the number and age of transfused allograft red blood cells on mortality and morbidity.

Methods: 1381 elderly patients with hip fractures were retrospectively analyzed. The cutoff between “new” and “old” ABT was defined as 14 days from donation (new, 1-14 days; old, 14-30 days). Kaplan-Meier curves were used to assess survival. Log-rank test was used to examine the differences between the five groups (no ABTs, one new ABT, one old ABT, two new ABTs, and two old ABTs). A su-group analysis comparing 2 old ABTs (95 patients) versus 2 new ABTs (138 patients) with regard to cardiac, pulmonary, thromboembolic, and infective complications was also conducted.

Results: Kaplan-Meier survival curves differed significantly (P = 0.008) between the five groups of patients. Patients who did not receive ABT (718 patients) showed the best survival. In descending order of survival, patients who received one new ABT (243 patients), one old ABT (187 patients), two new ABTs (138 patients), and two old ABTs (95 patients) fared worse. When controlling for age and gender, this trend of survival was still evident but not significant. On subgroup analysis of two old versus two new ABTs, there were no differences in postoperative complications.

Conclusion: Patients undergoing surgery for hip fractures who received more units of old ABT had a significantly decreased survival rate compared to those who received new ABTs and fewer transfusions.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.