The Comparison of Pre and Post-Operative Hemoglobin Level in Elderly Undergoing Major Orthopedic Surgery

Abstract

Background: Anemia is a common disease in older patients and prevalence of anemia increases with high age. Preoperative anemia is associated with high mortality after surgery. The severity of anemia is variable and is affected by blood loss volume, pre-operative hemoglobin (Hb) value and transfusion during surgery. However, the strategies of blood management for optimization of Hb before surgery are more important. Therefore, surgery and anesthesia teams always follow these issues: how we can decrease intraoperative blood loss and complications of bleeding and transfusion? However, the aim of study was comparison of Hb in pre- and post- operative period in older patients undergoing major orthopedic operation.
 Methods: A descriptive cross-sectional study was conducted on 230 patients aged more than 65 years who underwent orthopedic surgery from 2016 through 2017. Hb value was measured after and before surgery and compared.
 Results: The mean age of participants was 75.8. 54.3% of cases were female. Most of the patients (70.4%) had concurrent disease such as hypertension, diabetes mellitus and heart disease. The most common types of surgery were as follows: DHS, total replacement of knee and hip bipolar hemiarthroplasty. The mean difference value of Hb in pre and post– operative period was significant and was reduced from 12.6 to 10.3g/dL.
 Conclusion: The mean difference value of Hb in pre and post– operative period was significant. However, orthopedic surgeries can reduce Hb in older patients. In regard to older subjects being considered as high-risk group, routine control and proper correction of Hb in such operations is necessary.