Evidence map›Paper›PMID 40021592›Full record

ReviewJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2025

Intra-operative blood transfusions raise the risk of postoperative delirium and impede functional recovery in elderly hip fracture patients: a propensity score-matched study.

Yanan Li, Tao Wang, Jiajie Zhang, Zhiqian Wang, Junfei Guo, Qi Zhang

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Antibiofilm-coated intramedullary nailing for tibial and femoral diaphyseal fractures at high-risk infection: outcomes of 103 consecutive patients.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026
    Observational
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yanan Li *Department of Anesthesiology, The Third Hospital of Hebei Medical University, Hebei, China.
Tao Wang *Department of Lower Limb Trauma, Beijing Jishuitan Hospital, Guizhou Hospital, Guizhou, China.
Jiajie ZhangDepartment of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang City, Hebei, 050031, China.
Zhiqian WangDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Junfei GuoDepartment of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, No.555 Youyi East Road, Xi'an City, 710001, China. drjfguo@163.com.
Qi ZhangDepartment of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang City, Hebei, 050031, China. zhangqivictory@163.com.ORCID http://orcid.org/0000-0003-0727-1607

Funding

National Natural Science Foundation of China 82301382Natural Science Foundation of Hebei Province H2023206018
6 · The paper itself

Abstract

backgroundThis retrospective analysis was performed to investigate the potential influence of intra-operative blood transfusion (IBT) in patients aged 65 years or older with intertrochanteric fractures (IF) who underwent intramedullary fixation.

methodsThe outcomes of interest included the incidence of postoperative delirium (POD), pain score at discharge, length of hospital stay (LOS), functional outcomes, and mortality. The study included all surgically treated patients with IF between Jan. 2018 and Dec. 2021. Data on patient demographics, injury-related factors, surgical procedures, intraoperative details, in-hospital information, and postoperative outcomes were collected. In order to mitigate potential confounding and selection bias, the researchers employed the propensity score matching (PSM) technique using a 1:1 ratio via the caliper matching method. Following PSM, the association between IBT and outcome analyses was assessed using McNemar's Chi-square tests. Additionally, the Spearman correlations between IBT, POD and postoperative functional outcomes were computed.

resultsOut of the initial 2159 consecutive patients screened, a final sample of 1681 individuals was included, consisting of 1278 in the non-IBT group and 403 in the IBT group. After PSM, each group comprised 298 participants. The disparities in POD rate and functional outcomes became significant after employing propensity score-based matching (P < 0.001 and 0.029, respectively), despite their lack of significance prior to matching. There were no notable distinctions observed in other operation-related data, LOS, and crude mortality rates at 30-day, 90-day, and 12-month intervals before and after PSM. Furthermore, incidence of POD (P = 0.006) and functional outcomes (P = 0.013) were significantly associated with IBT.

conclusionIn conclusion, IBT significantly increases the incidence of POD and hinders postoperative functional recovery in elderly patients with hip fracture.

Indexed as

Blood TransfusionDeliriumFracture Fixation, IntramedullaryHip FracturesIntraoperative CarePostoperative ComplicationsTransfusion ReactionAgedAged, 80 and overFemaleHumansIncidenceLength of StayMalePropensity ScoreRecovery of FunctionBlood transfusionElderlyIntertrochanteric fracturesPostoperative deliriumPostoperative outcomePropensity score matchingRetrospective study

Identifiers

PMID40021592
PMCPMC11871276

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.