Preoperative Anemia and Risk of In-hospital Postoperative Complications in Patients with Hip Fracture

Yu Jiang,1,&ast; Xisheng Lin,2,&ast; Yilin Wang,1 Jia Li,1,3 Guoqi Wang,4 Yutong Meng,5 Ming Li,1,3 Yi Li,1,3 Yan Luo,1,3 Zefu Gao,1 Pengbin Yin,1,3 Licheng Zhang,1,3 Houchen Lyu,1,3 Peifu Tang1,3 1Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Rehabilitation, the Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 3National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, People’s Republic of China; 4Department of Pediatrics, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 5Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Houchen Lyu; Peifu Tang, Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People’s Republic of China, Tel +86-13501149301, Email houchenlyu@301hospital.com.cn; pftang301@126.comPurpose: To evaluate the impact of preoperative anemia on postoperative complications after hip fracture surgery.Patients and Methods: We conducted a retrospective study including hip fracture patients at a teaching hospital between 2005 and 2022. We defined preoperative anemia as the last hemoglobin measurement level before surgery < 130 g/L for men and < 120 g/L for women. The primary outcome was a composite of in-hospital major complications, including pneumonia, respiratory failure, gastrointestinal bleeding, urinary tract infection, incision infection, deep venous thrombosis, pulmonary embolism, angina pectoris, arrhythmia, myocardial infarction, heart failure, stroke, and death. Secondary outcomes were cardiovascular events, infection, pneumonia, and death. We used multivariate negative binomial or logistic regression to evaluate the impact of anemia and its severity, categorized as mild (90–