Clinical study of recombinant human erythropoietin combined with iron to correct perioperative anemia in elderly patients with intertrochanteric fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LONG Ye , WANG Tong , LIU Jiaxin , DUAN Xin ,  XIANG Zhou

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

XIANG Zhou, Email: xiangzhou15@hotmail.com

Keywords：

Intertrochanteric fracture; anemia; recombinant human erythropoietin; iron; elderly patient

DOI：

10.7507/1002-1892.201812121

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of recombinant human erythropoietin (rHuEPO) combined with iron in treatment of anemia in elderly patients with intertrochanteric fractures during perioperative period. Methods A clinical data of 71 patients with intertrochanteric fractures met the inclusion criteria between April 2016 and October 2017 was retrospectively analyzed. All patients were treated with closed reduction and proximal femoral intramedullary nail fixation. Thirty-one patients were treated with rHuEPO and iron before operation as trial group, and 40 patients were not treated with rHuEPO and iron as control group. There was no significant difference in gender, age, body mass index, cause of injury, fracture side and classification, American Society of Anesthesiologists (ASA) classification, combined medical diseases, time from fracture to admission, preoperative hospital stay, and operation time between the two groups (P>0.05).The hemoglobin levels before operation and at 1, 3, and 7 days after operation, number of blood transfusion, blood transfusion rate, blood transfusion volume, postoperative hospital stay, complications were recorded and compared. Results After operation, 8 patients (25.8%) in trial group and 22 patients (55.0%) in control group received blood transfusion; the blood transfusion volume was (1.96±0.85) units in trial group and (3.19±1.61) units in control group. There were significant differences in blood transfusion rate and volume between the two groups (P<0.05). There was no significant difference in preoperative hemoglobin level between the two groups (P>0.05). The postoperative hemoglobin level was higher in trial group than in control group, and the difference between the two groups was significant at 7 days (P<0.05). The postoperative hospital stay was (6.16±3.97) days in trial group and (9.25±4.47) days in control group, showing significant difference between the two groups (P<0.05). There were 8 patients (25.8%) with pulmonary infection in trial group and 14 (35.0%) in control group after operation; 6 patients (19.4%) with deep venous thrombosis in trial group and 8 (20.0%) in control group. There was no significant difference in the incidences of complications between the two groups (P>0.05). All patients were discharged from hospital normally, and no one died during hospitalization. Conclusion The application of rHuEPO combined with iron before operation in elderly patients with intertrochanteric fractures can rapidly increase the hemoglobin level after operation, shorten the hospital stay, and do not increase the risk of deep venous thrombosis after operation.

Citation： LONG Ye, WANG Tong, LIU Jiaxin, DUAN Xin, XIANG Zhou. Clinical study of recombinant human erythropoietin combined with iron to correct perioperative anemia in elderly patients with intertrochanteric fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 662-665. doi: 10.7507/1002-1892.201812121 Copy

1.	丁涛, 张保焜, 田少奇, 等. 老年髋部骨折手术方法的选择原则及应用现状. 中国修复重建外科杂志, 2018, 32(11): 1435-1440.
2.	刘鹏, 杨林, 王专. 蔗糖铁联合重组人促红细胞生成素在老年髋关节骨折中的应用价值. 中国医学前沿杂志(电子版), 2017, 9(5): 96-101.
3.	Ho CA, Li CY, Hsieh KS, et al. Factors determining the 1-year survival after operated hip fracture: a hospital-based analysis. J Orthop Sci, 2010, 15(1): 30-37.
4.	安帅, 刘利民, 贺红梅, 等. 促红细胞生成素在老年转子间骨折治疗中的应用. 北京医学, 2017, 39(4): 351-355.
5.	García-Erce JA, Cuenca J, Muñoz M, et al. Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study. Vox Sanguinis, 2005, 88(4): 235-243.
6.	郭永贤, 宋世江, 李兴晶. 重组人促红素联合铁剂在老年股骨转子间骨折患者中的应用效果. 中国当代医药, 2018, 25(21): 34-36, 72.
7.	万乾, 张擎柱, 张义, 等. 股骨近端防旋髓内钉与锁定加压钢板治疗老年脑梗死偏瘫侧股骨转子间骨折的疗效比较. 中国修复重建外科杂志, 2018, 32(11): 1411-1416.
8.	Mazzola P, Bellelli G, Broggini V, et al. Postoperative delirium and pre-fracture disability predict 6-month mortality among the oldest old hip fracture patients. Aging Clin Exp Res, 2015, 27(1): 53-60.
9.	王晓冬, 姜媛媛, 潘浩, 等. 髓内钉治疗股骨转子间骨折围术期隐性失血的临床分析. 中国医药导报, 2013, 10(25): 42-44.
10.	曾文, 吴伟, 钟喜红. 围手术期应用重组人红细胞生成素对髋关节置换患者血小板参数、血红蛋白水平和康复进程的影响. 实用医院临床杂志, 2018, 15(1): 86-89.
11.	王善超, 孙卫平, 王海波, 等. 促红细胞生成素对髋膝关节置换手术出血的影响. 中国生化药物杂志, 2017, 37(3): 72-74.
12.	Huang H, Xin J, Ma B. Analysis of complications of intertrochanteric fracture treated with Gamma 3 intramedullary nail. Int J Clin Exp Med, 2014, 7(10): 3687-3693.
13.	卢国平, 戴杰, 洪晓亮, 等. 老年高龄髋部骨折患者围手术期隐性失血的相关性研究. 中华骨科杂志, 2017, 37(12): 728-734.
14.	寇红伟, 魏琛, 刘宏建, 等. 重组人促红细胞生成素对腰椎退变性侧弯术后快速康复的影响. 中华实验外科杂志, 2017, 34(4): 700-702.
15.	Schmidt AH, Templeman DC, Kyle RF. Blood conservation in hip trauma. Clin Orthop Relat Res, 1998, (357): 68-73.
16.	刘国印, 贾小宝, 张勇, 等. 老年人营养状况与髋部骨折术前隐性失血的相关性研究. 中华骨与关节外科杂志, 2018, 11(1): 15-19.
17.	谢添, 马彬彬, 李荥娟, 等. 加速康复外科在老年髋部骨折的研究现状. 中国修复重建外科杂志, 2018, 32(8): 1038-1046.
18.	刘欣伟, 王宁, 何勇, 等. 重组人促红素联合蔗糖铁用于双膝类风湿性关节炎围术期红细胞动员1例. 创伤与急危重病医学, 2016, 4(4): 218-219.
19.	Kateros K, Sakellariou VI, Sofianos IP, et al. Epoetin alfa reduces blood transfusion requirements in patients with intertrochanteric fracture. J Crit Care, 2010, 25(2): 348-353.
20.	李璐兵, 韩然, 王雪, 等. 重组人红细胞生成素联合铁剂治疗在髋膝关节置换术贫血患者中的应用研究. 实用骨科杂志, 2016, 22(10): 898-901.
21.	周琦, 周义钦, 赵辉, 等. 老年患者全膝和全髋关节置换术围手术期血红蛋白及红细胞压积的转归. 中华骨科杂志, 2015, 35(3): 261-267.
22.	张静萍, 刘欣伟, 韩文锋, 等. 重组人促红细胞生成素联合氨甲环酸在高龄股骨颈骨折全髋关节置换术围术期血液管理中应用. 临床军医杂志, 2016, 44(9): 889-891.
23.	Brunskill SJ, Millette SL, Shokoohi Ali, et al. Red blood cell transfusion for people undergoing hip fracture surgery. Cochrane Database Syst Rev, 2015, 4: CD009699.
24.	Schneider MM, Kendoff D, Oloughlin PF, et al. Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty. Technol Health Care, 2014, 22(1): 123-128.

1. 丁涛, 张保焜, 田少奇, 等. 老年髋部骨折手术方法的选择原则及应用现状. 中国修复重建外科杂志, 2018, 32(11): 1435-1440.
2. 刘鹏, 杨林, 王专. 蔗糖铁联合重组人促红细胞生成素在老年髋关节骨折中的应用价值. 中国医学前沿杂志(电子版), 2017, 9(5): 96-101.
3. Ho CA, Li CY, Hsieh KS, et al. Factors determining the 1-year survival after operated hip fracture: a hospital-based analysis. J Orthop Sci, 2010, 15(1): 30-37.
4. 安帅, 刘利民, 贺红梅, 等. 促红细胞生成素在老年转子间骨折治疗中的应用. 北京医学, 2017, 39(4): 351-355.
5. García-Erce JA, Cuenca J, Muñoz M, et al. Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study. Vox Sanguinis, 2005, 88(4): 235-243.
6. 郭永贤, 宋世江, 李兴晶. 重组人促红素联合铁剂在老年股骨转子间骨折患者中的应用效果. 中国当代医药, 2018, 25(21): 34-36, 72.
7. 万乾, 张擎柱, 张义, 等. 股骨近端防旋髓内钉与锁定加压钢板治疗老年脑梗死偏瘫侧股骨转子间骨折的疗效比较. 中国修复重建外科杂志, 2018, 32(11): 1411-1416.
8. Mazzola P, Bellelli G, Broggini V, et al. Postoperative delirium and pre-fracture disability predict 6-month mortality among the oldest old hip fracture patients. Aging Clin Exp Res, 2015, 27(1): 53-60.
9. 王晓冬, 姜媛媛, 潘浩, 等. 髓内钉治疗股骨转子间骨折围术期隐性失血的临床分析. 中国医药导报, 2013, 10(25): 42-44.
10. 曾文, 吴伟, 钟喜红. 围手术期应用重组人红细胞生成素对髋关节置换患者血小板参数、血红蛋白水平和康复进程的影响. 实用医院临床杂志, 2018, 15(1): 86-89.
11. 王善超, 孙卫平, 王海波, 等. 促红细胞生成素对髋膝关节置换手术出血的影响. 中国生化药物杂志, 2017, 37(3): 72-74.
12. Huang H, Xin J, Ma B. Analysis of complications of intertrochanteric fracture treated with Gamma 3 intramedullary nail. Int J Clin Exp Med, 2014, 7(10): 3687-3693.
13. 卢国平, 戴杰, 洪晓亮, 等. 老年高龄髋部骨折患者围手术期隐性失血的相关性研究. 中华骨科杂志, 2017, 37(12): 728-734.
14. 寇红伟, 魏琛, 刘宏建, 等. 重组人促红细胞生成素对腰椎退变性侧弯术后快速康复的影响. 中华实验外科杂志, 2017, 34(4): 700-702.
15. Schmidt AH, Templeman DC, Kyle RF. Blood conservation in hip trauma. Clin Orthop Relat Res, 1998, (357): 68-73.
16. 刘国印, 贾小宝, 张勇, 等. 老年人营养状况与髋部骨折术前隐性失血的相关性研究. 中华骨与关节外科杂志, 2018, 11(1): 15-19.
17. 谢添, 马彬彬, 李荥娟, 等. 加速康复外科在老年髋部骨折的研究现状. 中国修复重建外科杂志, 2018, 32(8): 1038-1046.
18. 刘欣伟, 王宁, 何勇, 等. 重组人促红素联合蔗糖铁用于双膝类风湿性关节炎围术期红细胞动员1例. 创伤与急危重病医学, 2016, 4(4): 218-219.
19. Kateros K, Sakellariou VI, Sofianos IP, et al. Epoetin alfa reduces blood transfusion requirements in patients with intertrochanteric fracture. J Crit Care, 2010, 25(2): 348-353.
20. 李璐兵, 韩然, 王雪, 等. 重组人红细胞生成素联合铁剂治疗在髋膝关节置换术贫血患者中的应用研究. 实用骨科杂志, 2016, 22(10): 898-901.
21. 周琦, 周义钦, 赵辉, 等. 老年患者全膝和全髋关节置换术围手术期血红蛋白及红细胞压积的转归. 中华骨科杂志, 2015, 35(3): 261-267.
22. 张静萍, 刘欣伟, 韩文锋, 等. 重组人促红细胞生成素联合氨甲环酸在高龄股骨颈骨折全髋关节置换术围术期血液管理中应用. 临床军医杂志, 2016, 44(9): 889-891.
23. Brunskill SJ, Millette SL, Shokoohi Ali, et al. Red blood cell transfusion for people undergoing hip fracture surgery. Cochrane Database Syst Rev, 2015, 4: CD009699.
24. Schneider MM, Kendoff D, Oloughlin PF, et al. Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty. Technol Health Care, 2014, 22(1): 123-128.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical study of recombinant human erythropoietin combined with iron to correct perioperative anemia in elderly patients with intertrochanteric fractures

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content