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Elderly with hip fractures are often fragile and discharged from hospital after few days of hospitalisation. Hip fracture surgery is often associated with blood loss, where the patient is at risk of developing anaemia. A low haemoglobin solution reduces the body's oxygen transport which causes an impaired functional level and strain on vital organs. Acute anaemia is also tolerated worse in elderly, than in younger patients. Therefore this study aim's is to investigate whether there are effects of an expanded indication for blood transfusion in the frail elderly.
All elderly patients aged 65 and above who are hospitalised from nursing home or senior housing to the Orthopaedic Surgery Ward at Aarhus University Hospital with hip fracture and treated operatively, are participants in the study. According to sample size calculations 284 patients are needed. Patients must before surgery give informed consent or there must be deputy informed consent if the patient is incompetent. Inclusion is dependent on if the outcome of haemoglobin is measured ≥ 6 and < 7mmol latest 6th days after surgery. Randomisation will be computerised. Randomisation will determine intervention with blood transfusion and the measurement of haemoglobin is blinded to patient, relatives and the primary sector. Both intervention, and control groups will receive blood when haemoglobin is less than 6 mmol/l, as recommended by the Danish Board of Health. Geriatric and Orthopaedic Team (GO-team), consisting of following trained specialists: physiotherapist, nurse and doctor, will conduct the medical examinations, including blood transfusions, from admission until 30 days after surgery. GO team will work on weekdays both at the orthopaedic surgery ward and in the patients home immediately after discharge. In accordance with Aarhus Blood Bank's instructions, blood transfusions are given both under hospitalisation, in nursing homes and in senior housing. Outcomes are functional ability after 10 days, quality of life and mortality after 30 days. The test for measuring the level of functionality and quality of life will be performed by a blinded therapist.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
Research Unit, Geriatric Department, Aarhus University Hospital
Central Denmark Region
Aarhus University Hospital
Published on BioPortfolio: 2014-08-27T03:14:39-0400
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