SynthesisMedicine2019
Restrictive versus liberal strategy for red blood-cell transfusion in hip fracture patients: A systematic review and meta-analysis.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Mortality and Functional Outcomes of Liberal versus Restrictive Blood Transfusion in Elderly Patients after Hip Surgery: A Randomised Control Trial.Hip & pelvis · 2026Article
- Chronic anticoagulation therapy associated with increased complications following hemiarthroplasty in hip fracture patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Article
- Predicting Postoperative Blood Transfusion in Elderly Patients Undergoing Total Hip and Knee Arthroplasty Using Machine Learning Models.Risk management and healthcare policy · 2025Article
- Preoperative Anaemia Increases the Likelihood of 1-Year Mortality After Hip Fracture.Advances in orthopedics · 2025Article
- Establishment of a predictive model for blood transfusion after femoral head replacement in elderly patients.Joint diseases and related surgery · 2024Article
- Consequences of anemia in geriatric hip fractures: how low is too low?Trauma surgery & acute care open · 2024Article
- The Impact of Blood Transfusion in Developing Postoperative Delirium in Patients with Hip Fracture Surgery.Journal of clinical medicine · 2023Article
- Perioperative blood transfusion in major abdominal cancer surgery: a multi-centre service evaluation and national survey.BJA open · 2022Article
- Postoperative haemoglobin estimation in elderly hip fractures.Aging medicine (Milton (N.S.W)) · 2021Article
- Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram.Journal of orthopaedic surgery and research · 2021Article
- Sarcopenia is associated with blood transfusions in head and neck cancer free flap surgery.Laryngoscope investigative otolaryngology · 2021Article
- Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture.International journal of environmental research and public health · 2021Review
- Hip Fracture Surgery without Transfusion in Patients with Hemoglobin Less Than 10 g/dL.Clinics in orthopedic surgery · 2021Article
- Allogeneic Red Blood Cell Transfusion Rate and Risk Factors After Hemiarthroplasty in Elderly Patients With Femoral Neck Fracture.Frontiers in physiology · 2021Article
- Red Blood Cell Transfusion and Postoperative Delirium in Hip Fracture Surgery Patients: A Retrospective Observational Cohort Study.Anesthesiology research and practice · 2021Article
- Development of a Nomogram for Predicting Blood Transfusion Risk After Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost clinical guidelines recommend a restrictive red-blood-cell (RBC) transfusion threshold. However, indications for transfusion in patients with a hip fracture have not been definitively evaluated or remain controversial. We compared the pros and cons of restrictive versus liberal transfusion strategies in patients undergoing hip fracture surgery.
methodsElectronic databases were searched to identify randomized controlled trials (RCTs) and retrospective cohort studies (RCSs) to investigate the effects of a restrictive strategy versus its liberal counterpart in patients undergoing hip fracture surgery. The main clinical outcomes included delirium, mortality, infections, cardiogenic complications, thromboembolic events, cerebrovascular accidents, and length of hospital stay. The meta-analysis program of the Cochrane Collaboration (RevMan version 5.3.0) was used for data analysis. Statistical heterogeneity was assessed by both Cochran chi-squared test (Q test) and I test. Both Begg and Egger tests were used to assess potential publication bias.
resultsWe identified 7 eligible RCTs and 2 eligible RCSs, involving 3,575 patients in total. In patients undergoing hip fracture surgery, we found no differences in frequency of delirium, mortality, the incidence rates of all infections, pneumonia, wound infection, all cardiovascular events, congestive heart failure, thromboembolic events or length of hospital stay between restrictive and liberal thresholds for RBC transfusion (P >.05). However, we found that the use of restrictive transfusion thresholds is associated with higher rates of acute coronary syndrome (P <.05) while liberal transfusion thresholds increase the risk of cerebrovascular accidents (P <.05).
conclusionIn patients undergoing hip fracture surgery, clinicians should evaluate the patient's condition in detail and adopt different transfusion strategies according to the patient's specific situation rather than merely using a certain transfusion strategy.
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