Hip Fracture - Quality Statement 7: Postoperative Blood Transfusions

Resources Quality Statements Advisory Committee About

Postoperative Blood Transfusions

Patients with hip fracture do not receive blood transfusions if they are asymptomatic and have a postoperative hemoglobin level equal to or higher than 80g/L.

Background

A restrictive blood transfusion strategy for hip fracture patients, in which medically stable patients with a hemoglobin level equal to or higher than 80 g/L do not receive transfusions, has been found to be safe compared to less restrictive transfusion thresholds.

What This Quality Statement Means

For Patients

You should receive a blood transfusion after hip fracture surgery only if your hemoglobin is very low (below 80 g/L).

For Clinicians

Do not routinely perform postoperative blood transfusions for hip fracture patients if they have a hemoglobin level equal to or higher than 80 g/L.

For Health Services

Ensure that protocols, pathways, medical directives, and standardized order sets include reference to restrictive blood transfusion recommendations for postoperative hip fracture patients.

Quality Indicators

Process Indicator

Percentage of patients who undergo hip fracture surgery, have a postoperative hemoglobin level equal to or higher than 80 g/L, and who receive a blood transfusion

Denominator: total number of adults with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture and have a postoperative hemoglobin level equal to or higher than 80 g/L
Numerator: number of patients in the denominator who receive a blood transfusion
Data source: local data collection

Evidence to Improve Care