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.	丁濤, 張保焜, 田少奇, 等. 老年髖部骨折手術方法的選擇原則及應用現狀. 中國修復重建外科雜志, 2018, 32(11): 1435-1440.
2.	劉鵬, 楊林, 王專. 蔗糖鐵聯合重組人促紅細胞生成素在老年髖關節骨折中的應用價值. 中國醫學前沿雜志(電子版), 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.	安帥, 劉利民, 賀紅梅, 等. 促紅細胞生成素在老年轉子間骨折治療中的應用. 北京醫學, 2017, 39(4): 351-355.
5.	García-Erce JA, Cuenca J, Mu?oz 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.	郭永賢, 宋世江, 李興晶. 重組人促紅素聯合鐵劑在老年股骨轉子間骨折患者中的應用效果. 中國當代醫藥, 2018, 25(21): 34-36, 72.
7.	萬乾, 張擎柱, 張義, 等. 股骨近端防旋髓內釘與鎖定加壓鋼板治療老年腦梗死偏癱側股骨轉子間骨折的療效比較. 中國修復重建外科雜志, 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.	王曉冬, 姜媛媛, 潘浩, 等. 髓內釘治療股骨轉子間骨折圍術期隱性失血的臨床分析. 中國醫藥導報, 2013, 10(25): 42-44.
10.	曾文, 吳偉, 鐘喜紅. 圍手術期應用重組人紅細胞生成素對髖關節置換患者血小板參數、血紅蛋白水平和康復進程的影響. 實用醫院臨床雜志, 2018, 15(1): 86-89.
11.	王善超, 孫衛平, 王海波, 等. 促紅細胞生成素對髖膝關節置換手術出血的影響. 中國生化藥物雜志, 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.	盧國平, 戴杰, 洪曉亮, 等. 老年高齡髖部骨折患者圍手術期隱性失血的相關性研究. 中華骨科雜志, 2017, 37(12): 728-734.
14.	寇紅偉, 魏琛, 劉宏建, 等. 重組人促紅細胞生成素對腰椎退變性側彎術后快速康復的影響. 中華實驗外科雜志, 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.	劉國印, 賈小寶, 張勇, 等. 老年人營養狀況與髖部骨折術前隱性失血的相關性研究. 中華骨與關節外科雜志, 2018, 11(1): 15-19.
17.	謝添, 馬彬彬, 李滎娟, 等. 加速康復外科在老年髖部骨折的研究現狀. 中國修復重建外科雜志, 2018, 32(8): 1038-1046.
18.	劉欣偉, 王寧, 何勇, 等. 重組人促紅素聯合蔗糖鐵用于雙膝類風濕性關節炎圍術期紅細胞動員1例. 創傷與急危重病醫學, 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, 韓然, 王雪, 等. 重組人紅細胞生成素聯合鐵劑治療在髖膝關節置換術貧血患者中的應用研究. 實用骨科雜志, 2016, 22(10): 898-901.
21.	周琦, 周義欽, 趙輝, 等. 老年患者全膝和全髖關節置換術圍手術期血紅蛋白及紅細胞壓積的轉歸. 中華骨科雜志, 2015, 35(3): 261-267.
22.	張靜萍, 劉欣偉, 韓文鋒, 等. 重組人促紅細胞生成素聯合氨甲環酸在高齡股骨頸骨折全髖關節置換術圍術期血液管理中應用. 臨床軍醫雜志, 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. 丁濤, 張保焜, 田少奇, 等. 老年髖部骨折手術方法的選擇原則及應用現狀. 中國修復重建外科雜志, 2018, 32(11): 1435-1440.
2. 劉鵬, 楊林, 王專. 蔗糖鐵聯合重組人促紅細胞生成素在老年髖關節骨折中的應用價值. 中國醫學前沿雜志(電子版), 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. 安帥, 劉利民, 賀紅梅, 等. 促紅細胞生成素在老年轉子間骨折治療中的應用. 北京醫學, 2017, 39(4): 351-355.
5. García-Erce JA, Cuenca J, Mu?oz 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. 郭永賢, 宋世江, 李興晶. 重組人促紅素聯合鐵劑在老年股骨轉子間骨折患者中的應用效果. 中國當代醫藥, 2018, 25(21): 34-36, 72.
7. 萬乾, 張擎柱, 張義, 等. 股骨近端防旋髓內釘與鎖定加壓鋼板治療老年腦梗死偏癱側股骨轉子間骨折的療效比較. 中國修復重建外科雜志, 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. 王曉冬, 姜媛媛, 潘浩, 等. 髓內釘治療股骨轉子間骨折圍術期隱性失血的臨床分析. 中國醫藥導報, 2013, 10(25): 42-44.
10. 曾文, 吳偉, 鐘喜紅. 圍手術期應用重組人紅細胞生成素對髖關節置換患者血小板參數、血紅蛋白水平和康復進程的影響. 實用醫院臨床雜志, 2018, 15(1): 86-89.
11. 王善超, 孫衛平, 王海波, 等. 促紅細胞生成素對髖膝關節置換手術出血的影響. 中國生化藥物雜志, 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. 盧國平, 戴杰, 洪曉亮, 等. 老年高齡髖部骨折患者圍手術期隱性失血的相關性研究. 中華骨科雜志, 2017, 37(12): 728-734.
14. 寇紅偉, 魏琛, 劉宏建, 等. 重組人促紅細胞生成素對腰椎退變性側彎術后快速康復的影響. 中華實驗外科雜志, 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. 劉國印, 賈小寶, 張勇, 等. 老年人營養狀況與髖部骨折術前隱性失血的相關性研究. 中華骨與關節外科雜志, 2018, 11(1): 15-19.
17. 謝添, 馬彬彬, 李滎娟, 等. 加速康復外科在老年髖部骨折的研究現狀. 中國修復重建外科雜志, 2018, 32(8): 1038-1046.
18. 劉欣偉, 王寧, 何勇, 等. 重組人促紅素聯合蔗糖鐵用于雙膝類風濕性關節炎圍術期紅細胞動員1例. 創傷與急危重病醫學, 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, 韓然, 王雪, 等. 重組人紅細胞生成素聯合鐵劑治療在髖膝關節置換術貧血患者中的應用研究. 實用骨科雜志, 2016, 22(10): 898-901.
21. 周琦, 周義欽, 趙輝, 等. 老年患者全膝和全髖關節置換術圍手術期血紅蛋白及紅細胞壓積的轉歸. 中華骨科雜志, 2015, 35(3): 261-267.
22. 張靜萍, 劉欣偉, 韓文鋒, 等. 重組人促紅細胞生成素聯合氨甲環酸在高齡股骨頸骨折全髖關節置換術圍術期血液管理中應用. 臨床軍醫雜志, 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