Resuscitation in hip fractures: A systematic review

Brett Rocos*, Michael R. Whitehouse, Michael B Kelly

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

6 Citations (Scopus)
278 Downloads (Pure)

Abstract

To evaluate the evidence for the resuscitation of patients with hip fracture in the preoperative or perioperative phase of their treatment and its impact on mortality.

DESIGN: We searched MEDLINE, EMBASE, CENTRAL and PROSPERO databases using a systematic search strategy for randomised trials and observational studies investigating the fluid resuscitation of any patient with hip fracture. No language limits were applied to the search, which was complemented by manually screening the reference lists of appropriate studies.

OUTCOME MEASURES: Mortality at 1 week, 30 days and 1 year following surgery.

RESULTS: Two hundred and ninety-eight citations were identified, and 12 full manuscripts were reviewed; no studies satisfied the inclusion criteria. The background literature showed that the mortality for these patients at 30 days is approximately 8.5% and that bone cement implantation syndrome is insufficient to explain this. The literature was explored to define the need for an interventional investigation into the preoperative resuscitation of patients with hip fracture.

CONCLUSIONS: Patients with hip fracture show similar physiological disturbance to major trauma patients. Nineteen per cent of patients presenting with hip fracture are hypoperfused and 50% show preoperative anaemia suggesting that under resuscitation is a common problem that has not been investigated. A properly conducted interventional trial could improve the outcome of these vulnerable patients.

Original languageEnglish
Article numbere015906
Number of pages7
JournalBMJ Open
Volume7
Issue number4
Early online date4 May 2017
DOIs
Publication statusPublished - 4 May 2017

Structured keywords

  • Centre for Surgical Research

Keywords

  • Blood
  • Hip fracture
  • Mortality
  • Resuscitation
  • Trauma

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