Background: Previous smaller sized studies suggest that anaemia is a risk factor for mortality in hip fracture patients. We assessed the correlation between haemoglobin at admission with 30-days mortality following a hip fracture in a large-scale study.
Method: From January 1996 to November 2013, all hip fracture patients (> 60 yrs of age) admitted to Bispebjerg Hospital, Denmark, were identified using a dedicated local fracture database. We excluded conservatively treated patients and patients who died preoperatively. Prior co-morbid conditions were identified through linkage to the National Hospital Discharge Register.
Results: We identified 7755 consecutive hip fracture patients. Of these, 7647 (98.6%) had a haemoglobin measurement on admission and were thus eligible for further analysis. Mean haemoglobin for patients alive at 30 days was 7.6 (SD 1.0), and for deceased patients 7.4 (SD 1.1), p < 0.0001. Mean age was 82.5 years (SD 8.5) and 76.4% of the population were female (Nfemales =5845). The 30-days mortality in the 1st, 2nd, 3rd, and 4th quartiles of haemoglobin was 13.2%, 10.1%, 9.2% and 8.9%, respectively (p < 0.0001). In the multivariate analysis, the hazard ratio (HR) with 95% confidence interval (CI) for 30-days mortality in anaemic patients (< 7.3 mmol/L for females and < 8.5 mmol/L for males. Nanemic =3364) was 1.70 Cl [1.48-1.96], p < 0.0001. Adjusting for age, gender and co-morbidities (Charlson Score) slightly attenuated the risk estimate (HR 1.23 CI [1.05-1.42], p=0.0008)
Conclusion: This analysis indicates that anaemia at admission is significantly associated with 30-days mortality in hip fracture patients even after adjusting for comorbid diseases. This information might be used to identify patients with a higher risk of death using inexpensive and easily interpreted haemoglobin tests and thus results in intensified care in order to reduce the excess mortality.
Disclosure: The authors declared no competing interests.