Red Blood Cell Transfusion and Postoperative Delirium in Hip Fracture Surgery Patients: A Retrospective Observational Cohort Study
Table 1
Characteristics of all patients with eligible CPTs and complete study data.
Variable
No RBC transfusion
RBC transfusion
Standardized mean difference
N = 15,311
N = 5,527
Age (years)
78 ± 11
81 ± 10
0.29
Sex (% male)
5,078 (33.2)
1,437 (26.0)
0.16
Weight (kg)
69 ± 18
65 ± 17
0.23
Height (cm)
164 ± 11
162 ± 10
0.19
Hematocrit (%)
36 ± 5
31 ± 5
>0.99
Platelet count × 109/L
210 ± 79
198 ± 81
0.15
Creatinine (mg/dL)
1.0 ± 0.8
1.2 ± 0.9
0.23
INR
1.1 ± 0.2
1.1 ± 0.3
<0.01
Independent functional status at baseline
12,637 (82.5)
4,353 (78.8)
0.09
Diabetes mellitus
2,880 (18.8)
1,062 (19.2)
0.01
Hypertension requiring medication
9,933 (64.9)
3,898 (70.5)
0.12
Congestive heart failure
471 (3.1)
229 (4.1)
0.05
Tobacco use
2,071 (13.5)
503 (9.1)
0.14
COPD
1,668 (10.9)
644 (11.7)
0.03
Dialysis
291 (1.9)
149 (2.7)
0.05
Dementia
3,161 (20.7)
1,269 (23.0)
0.06
Disseminated cancer
514 (3.4)
219 (4.0)
0.03
Wound infection
513 (3.4)
275 (5.0)
0.08
Steroid use
882 (5.8)
408 (7.4)
0.06
Bleeding disorder
2,398 (15.7)
1,221 (22.1)
0.16
Transfused in 72 hours before surgery
392 (2.6)
510 (9.2)
0.28
Emergency surgery
4,475 (29.2)
1,648 (29.8)
0.31
Mortality probability (%)
4.6 ± 5.7
6.6 ± 7.1
Morbidity probability (%)
9.4 ± 4.5
10.8 ± 4.9
ASA class
I or II
3,014 (19.7)
681 (12.3)
0.30
III
9,496 (62.0)
3,536 (64.0)
0.04
IV or V
2,801 (18.3)
1,310 (23.7)
0.13
Anesthesia type
General
10,828 (70.7)
4,217 (76.3)
0.13
Spinal
3,300 (21.6)
1,004 (18.2)
0.09
MAC and local
1,072 (7.0)
271 (4.9)
0.09
Regional
111 (0.7)
35 (0.6)
0.01
CPT code
27236
6,243 (40.8)
1,191 (21.6)
0.42
27244
1,784 (11.7)
645 (11.7)
<0.01
27245
7,284 (47.5)
3,691 (66.8)
0.40
Duration of surgery (minutes)
64 ± 38
74 ± 48
0.23
ASA = American Society of Anesthesiologists, COPD = chronic obstructive pulmonary disease, CPT = current procedural terminology, INR = international normalized ratio, MAC = monitored anesthesia care, and RBC = red blood cell. CPT codes: 27236 (open treatment of femoral fracture, proximal end, neck, internal fixation, or prosthetic replacement), 27244 (treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture with plate/screw-type implant), and 27245 (treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture with intramedullary implant). Values are mean +sd or n (%). Timing of RBC transfusion: postoperative day (POD), POD0 = 1,356, POD1 = 1,977, POD2 = 1,683, POD3 = 493, and others = 18.
