Khow KS, Kee MW, Shibu PN, Yu SC, Chehade MJ, Visvanathan R. Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol. World J Meta-Anal 2019; 7(6): 290-296 [DOI: 10.13105/wjma.v7.i6.290]
Corresponding Author of This Article
Kareeann SF Khow, FRACP, MBChB, Research Fellow, Senior Lecturer, Staff Physician, Aged and Extended Care Services, the Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia. kareeann.khow@adelaide.edu.au
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Systematic Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Jun 30, 2019; 7(6): 290-296 Published online Jun 30, 2019. doi: 10.13105/wjma.v7.i6.290
Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol
Kareeann SF Khow, Michelle WK Kee, Pazhvoor N Shibu, Solomon CY Yu, Mellick J Chehade, Renuka Visvanathan
Kareeann SF Khow, Michelle WK Kee, Pazhvoor N Shibu, Solomon CY Yu, Renuka Visvanathan, Aged and Extended Care Services, the Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
Kareeann SF Khow, Pazhvoor N Shibu, Solomon CY Yu, Renuka Visvanathan, Centre of Research Excellence, Frailty Trans-disciplinary Research to Achieve Healthy Ageing, University of Adelaide, Adelaide, SA 5005, Australia
Mellick J Chehade, Discipline of Orthopaedics and Trauma, Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, SA 5005, Australia
Author contributions: Khow KSF, Kee MWK, Shibu PN, Yu SCY, Chehade MJ and Visvanathan R contributed equally to the work; Khow KSF conceptualized and designed the review together with Kee MWK; Khow KSF drafted the initial paper; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: Dr Shibu has received educational grants and honoraria from Novartis Pty Australia and Amgen Pty Ltd. Associate Professor Chehade has received institutional research grant from Stryker and Amgen Pty Ltd. Professor Visvanathan has participated in international initiatives funded by educational grants from Nestle and has presented at symposiums funded by Nestle. She is on the Malnutrition in the Elderly Board with Nestle Australia. Dr Khow, Dr Kee and Associate Professor Yu do not have any conflict of interests.
PRISMA 2009 Checklist statement: The manuscript is designed as per PRISMA 2009 guideline, and checklist is provided as supplementary file.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kareeann SF Khow, FRACP, MBChB, Research Fellow, Senior Lecturer, Staff Physician, Aged and Extended Care Services, the Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia. kareeann.khow@adelaide.edu.au
Telephone: +61-8-83132144 Fax: +61-8-83132155
Received: April 28, 2019 Peer-review started: April 28, 2019 First decision: May 9, 2019 Revised: June 1, 2019 Accepted: June 17, 2019 Article in press: June 17, 2019 Published online: June 30, 2019 Processing time: 63 Days and 17.2 Hours
Abstract
BACKGROUND
Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes.
AIM
To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes.
METHODS
Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery; Exposure: Perioperative anaemia; Comparison: No anaemia before or after hip fracture surgery; Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate.
CONCLUSION
This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.
Core tip: Hip fracture is a growing public health problem because of population aging. Recovery from hip fracture can be slow and complicated by morbidities and decline in functional abilities. Perioperative anaemia is common with hip fractures. However, it is uncertain at which time point haemoglobin level is most strongly associated with different clinical outcomes after hip fracture surgery. Better understanding of the relationship between perioperative haemoglobin and mortality, length of hospital stay, functional status, postoperative complications, hospital readmission and admission to residential care after discharge, is required.
