scholarly journals Retraction : The Prevention of Hip Fracture with Menatetrenone and Risedronate Plus Calcium Supplementation in Elderly Patients with Alzheimer Disease: A Randomized Controlled Trial

2010 ◽  
Vol 57 (4) ◽  
pp. 117-124 ◽  
Author(s):  
YOSHIHIRO SATO ◽  
YOSHIAKI HONDA ◽  
KAZUO UMENO ◽  
NORIMASA HAYASHIDA ◽  
JUN IWAMOTO ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Alzheimer Disease ◽  
Elderly Patients ◽  
Calcium Supplementation ◽  
Controlled Trial ◽  
Randomized Controlled

Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial

2021 ◽  
Vol 103-B (3) ◽  
pp. 442-448
Author(s):  
Vasileios S. Nikolaou ◽  
Panagiotis Masouros ◽  
Themistoklis Floros ◽  
Efstathios Chronopoulos ◽  
Maria Skertsou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Hip Fracture ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Total Blood ◽  
Subcapital Fracture ◽  
Randomized Controlled

Aims The aim of this study was to investigate the hypothesis that a single dose of tranexamic acid (TXA) would reduce blood loss and transfusion rates in elderly patients undergoing surgery for a subcapital or intertrochanteric (IT) fracture of the hip. Methods In this single-centre, randomized controlled trial, elderly patients undergoing surgery for a hip fracture, either hemiarthroplasty for a subcapital fracture or intramedullary nailing for an IT fracture, were screened for inclusion. Patients were randomly allocated to a study group using a sealed envelope. The TXA group consisted of 77 patients, (35 with a subcapital fracture and 42 with an IT fracture), and the control group consisted of 88 patients (29 with a subcapital fracture and 59 with an IT fracture). One dose of 15 mg/kg of intravenous (IV) TXA diluted in 100 ml normal saline (NS,) or one dose of IV placebo 100 ml NS were administered before the incision was made. The haemoglobin (Hb) concentration was measured before surgery and daily until the fourth postoperative day. The primary outcomes were the total blood loss and the rate of transfusion from the time of surgery to the fourth postoperative day. Results Homogeneity with respect to baseline characteristics was ensured between groups. The mean total blood loss was significantly lower in patients who received TXA (902.4 ml (-279.9 to 2,156.9) vs 1,226.3 ml (-269.7 to 3,429.7); p = 0.003), while the likelihood of requiring a transfusion of at least one unit of red blood cells was reduced by 22%. Subgroup analysis showed that these differences were larger in patients who had an IT fracture compared with those who had a subcapital fracture. Conclusion Elderly patients who undergo intramedullary nailing for an IT fracture can benefit from a single dose of 15 mg/kg TXA before the onset of surgery. A similar tendency was identified in patients undergoing hemiarthroplasty for a subcapital fracture but not to a statistically significant level. Cite this article: Bone Joint J 2021;103-B(3):442–448.

scholarly journals Intravenous Iron May Improve Outcomes in Elderly Patients With Operative Hip Fractures

2020 ◽  
Vol 11 ◽  
pp. 215145932091184
Author(s):  
Jamie L. Engel ◽  
Joseph N. Gabra ◽  
Patrick Kane ◽  
William J. Kurtz
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Readmission Rate ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Iv Iron

Introduction: Hip fractures are common injuries with high morbidity and mortality rates. These patients often become anemic and require allogenic blood transfusion. Transfusions are costly with potential complications. This study examines the effect of intravenous (IV) iron on patients with hip fractures, undergoing surgery within 48 hours, and being treated with a highly restrictive transfusion protocol. Materials and Methods: A retrospective chart review performed on patients admitted to a level 1 tertiary care center with fractures of the proximal femur from December 2015 to December 2017 included 239 patients. Patients who received 300 mg of IV iron when their hemoglobin fell below 11 g/dL were compared to a control group of patients who never received IV iron with respect to transfusion rate, 30-day readmission rate, nosocomial infections, length of stay, and hospital costs. Results: There were no significant differences in transfusion rates ( P = .118). There was a trend toward decreased length of stay ( P = .063) and 30-day readmission rates ( P = .051) with a 59% reduction in the odds of 30-day readmission when a patient received IV iron. There were no differences in nosocomial infection rates or cost of hospitalization. Discussion: This study presents a compelling argument for further research regarding the use of IV iron in elderly patients undergoing surgery for a hip fracture. Length of stay and transfusion rates are increased in patients with intertrochanteric fractures and undergoing intramedullary nailing. A higher number of these patients in the IV iron group may have falsely increased these rates. A prospective, randomized, controlled trial is needed to assess the true effects of perioperative IV iron. Conclusions: This study showed no significant benefit to IV iron use in elderly patients undergoing surgical treatment of hip fracture. The decrease in 30-day readmission rate should be further examined with a prospective randomized controlled trial.

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