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Objective:To investigate the effects of iron sucrose combined with recombinant human erythropoietin(EPO)on perioperative anemia and early functional recovery in elderly patients with intertrochanteric fractures.Methods:A retrospective comparative analysis was performed on 78 elderly patients who received PFNA treatment for intertrochanteric fractures in our hospital from July 2016 to December 2018.In the observation group, 40 cases were treated with iron sucrose combined with erythropoietin during the perioperative period.No perioperative intervention measures were taken for the control group.Hemoglobin(Hb)levels at 1, 3, 5, 7 days and before discharge and Harris scores of hip joints before surgery, 2 weeks and 3 months after surgery were compared between the two groups.Results:Hb levels were higher in the observation group than in the control group at 5 d[(98.8±8.6 g/L vs.92.2±8.5 g/L, t=3.389, P=0.001)]and 7 d[(105.4±8.9)g/L vs.(94.8±8.5)g/L, t=5.370, P=0.000]after surgery and before discharge[(115.4±8.6)g/L vs.(100.6±8.2)g/L, t=7.771, P=0.000]. Harris scores were higher in the observation group than in the control group 3 months after surgery(82.4±3.8 vs.75.8±2.5, t=8.933, P=0.000). Pearson' s correlation analysis showed that Hb levels at 5d and 7d after surgery were positively correlated with Harris scores at 3 months after surgery.Hb levels before discharge had an effect on Harris scores at 3 months after surgery. Conclusions:The combined administration of iron sucrose and EPO perioperatively can promote postoperative Hb recovery, reduce the incidence of anemia, accelerate early functional recovery and improve the quality of life in elderly patients with intertrochanteric fractures.
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Objective To analyze risk factors for the perioperative heart failure following hip fracture surgery in the aged patients.Methods The present study included 186 elderly patients(≥ 65 years)who had received hip fracture surgery from August 2009 to Janurary 2014 in our department.Their clinical data were analyzed to define risk factors for perioperative heart failure.Results Factors significantly affecting the perioperative heart failure included age,gender,hypertension,time from injury to operation,general health before injury,pain score,perioperative blood transfusion,perioperative human serum albumin transfusion,fluid infusion during operation,perioperative balance between daily fluid intake and output,perioperative temperature changing and heart diseases.A multivariate Logistic regression analysis revealed that the independent risk factors for perioperative heart failure included general health before injury (OR =21.967,P=0.000),perioperative balance between daily fluid intake and output (OR =19.349,P =0.005),heart diseases (OR =6.009,P =0.006).Conclusions In aged patients undergoing hip fracture repair operations the independent risk factors for perioperative heart failure include general health before injury,perioperative balance between daily fluid intake and output,heart diseases.Perioperative risk assessment and prevention are the keys of better prognosis.