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· DOS Abstracts
Impact of preadmission anti-inflammatory drug use on
the risk of allogeneic red blood cell transfusion in el-
derly hip fracture patients
Eva Natalia Glassou, Nickolaj Kristensen, Bjarne Møller, Christian Erikstrup, Torben
Bæk Hansen, Alma Becic Pedersen
University clinic of hand, hip and knee surgery, Department of Orthopedic Surgery,
Regional Hospital West Jutland; Department of Clinical Epidemiology, Aarhus Uni-
versity Hospital; Department of Clinical Immunology, Aarhus University Hospital;
Department of Clinical Immunology, Aarhus University Hospital; University clinic of
hand, hip and knee surgery, Department of Orthopedic Surgery, Regional Hospital
West Jutland; Department of Clinical Epidemiology, Aarhus University Hospital
Background:
Despite advances in techniques of orthopedic surgery and improve-
ment of pre- and postoperative treatment, hip fracture surgery is often associated
with blood loss causing postoperative anemia.
Purpose / Aim of Study:
Using red blood cell (RBC) transfusion as a surrogate
for post-operative bleeding, the aim was to investigate if prescription drugs with
anti-inflammatory properties such as NSAIDs, corticosteroids and statins increased
the risk of RBC transfusion within the first week after hip fracture surgery in elderly
patients in Denmark.
Materials and Methods:
56,420 surgery treated hip fracture patients aged 65
years or older registered in the Danish Multidisciplinary Hip Fracture Database in
2005-2013 were included. Information on treatment, transfusion, medication and
comorbidities were collected using national administrative and clinical databases.
Patients were categorized as non-users (no prescription ≤365 days prior to sur-
gery), former users (one prescription ≤ 91-365 days) and current users (one pre-
scription ≤ 90 days) of the three anti-inflammatory drugs. A log-binomial model
was used to estimate relative risks (RRs) for RBC transfusion within 7 days of sur-
gery and corresponding 95% confidence intervals (CIs). Adjustments were made for
patient and surgery related factors.
Findings / Results:
Current users of NSAIDs had an increased adjusted RR of trans-
fusion (1.07, CI: 1.04 - 1.11) compared to non- users. There were no increase or
decrease in RRs of transfusion for current users of corticosteroids and statins (0.97,
CI: 0.93 - 1.01 and 1.03, CI: 1.00 - 1.05, respectively).
Conclusions:
NSAID prescription within the last 90 days of a hip fracture surgery
resulted in an increased risk of RBC transfusion. Thus, prescription of NSAID can
be associated with an increased risk of post- operative bleeding in relation to hip
fracture surgery.
No conflicts of interest reported
12.