Purpose Proximal femoral (hip) fracture is common, serious, and costly. Increasing the amount and quality of rehabilitation post-hip fracture potentially improves patient outcomes. Process evaluation examined implementation, mechanisms, and context of the FEMuR intervention, a community rehabilitation programme. Despite patient-reported benefits, RCT found no improvement in quantitatively measured outcomes compared with usual rehabilitation care. Materials and methods Intervention was delivered across 13 sites. Embedded mixed methods evaluation using realist frameworks. Thematic analysis of semi-structured interviews (patients n = 39: intervention n = 20, control n = 19), carers (n = 2), therapists (n = 10), and recruiting staff (n = 7), plus descriptive analysis of workbooks, goal-setting diaries, and therapy records. Results Additional therapy sessions were valued by patients and staff; patients appreciated tailored, person-centred support. Therapists appreciated time to work holistically. However, there were disparities in intervention delivery. COVID-19 necessitated remote delivery, impacting therapist feedback and risk assessment. Impacting context and mechanism factors included patient motivation, therapist expertise, variable usual care, poor service integration, and pandemic restrictions limiting activities. Conclusions Despite high levels of acceptability, intervention implementation and fidelity were compromised. Process evaluation revealed important lessons for future rehabilitation research. Capturing patient-centred intangible benefits, accounting for implementation variations, and considering outcomes beyond standard measures are necessary to fully understand effectiveness.

Postoperative delirium (POD) is common after hip-fracture surgery in older adults and is associated with prolonged hospitalization, increased mortality, and long-term cognitive decline. Previous literature has indicated that dexmedetomidine may reduce delirium when given intra-operatively; however, the benefit of a single nocturnal infusion before surgery has not been evaluated. We hypothesize that pre-operative night-time dexmedetomidine improves sleep quality and attenuates neuro-inflammation, thereby decreasing POD incidence. This multicentre, randomized, double-blind, placebo-controlled trial will enroll 560 patients aged 65-90years undergoing hip-fracture surgery. Participants will be randomly assigned (1:1) to receive an overnight infusion of dexmedetomidine 0.2µg/kg·h or matching saline from 20:00 to 06:00 a.m. before surgery. The primary endpoint is the incidence of POD during the first 72h, assessed every 6h with the 3-Minute Diagnostic Confusion Assessment Method and the relative risk (95% CI) will be calculated using the chi-square test. Secondary outcomes include delirium severity and duration, pain scores, sleep quality, cognitive function at 30 and 180days, and plasma biomarkers. This protocol evaluates whether the night-before infusion of dexmedetomidine prevents POD in older adults undergoing hip-fracture surgery. If effective, the intervention could easily be implemented in routine peri-operative care. Chinese Clinical Trial Registry ChiCTR2400087107. Registered on 19 July 2024.

With population aging, hip fractures in elderly patients are a major medical problem. The impact of intraoperative hypotension (IOH) on adverse postoperative outcomes such as complications and mortality remains controversial. This study aimed to clarify this relationship for clinical guidance. A retrospective analysis was performed on patients over 65 years of age who had hip fracture surgery from July 2019 to Dec 2023. Patients were divided into IOH and No IOH groups. Propensity score matching (PSM) was used to reduce confounding factors. The primary outcome measures included postoperative complications (were grouped as one to two complications and three or more complications) and postoperative mortality. The secondary outcome measures included specific complications and length of hospital stay (LOS). After PSM, 546 patients were included. The IOH group had a higher proportion of patients with three or more postoperative complications (3.0% vs 0%). The total duration of IOH was an independent risk factor for both three or more postoperative complications and postoperative cardiovascular events. Postoperative delirium (POD) was associated with the total duration of IOH at a lower threshold (MAP ≤ 55 mmHg); mortality and acute kidney injury (AKI) incidence showed no significant differences between groups. Our results provide evidence of the associations between IOH and its detailed exposure metrics with adverse postoperative outcomes in elderly patients with hip fractures, and reveal that POD is associated with the total duration of IOH at a lower threshold (MAP ≤ 55 mmHg) in this population.

To determine if implementation of the HIP ATTACK protocol for hip fracture patients decreased delays in surgical fixation or post-operative mobilization. The primary hypothesis was that implementation of the HIP ATTACK protocols would improve time to surgery and time to mobilization. Design: This was a retrospective review of patients who underwent hip fracture surgery between January 2011 and January 2021. A single academic institution where HIP ATTACK protocols were implemented in September 2016. Patients >50 undergoing surgery for treatment of hip fractures (AO 31A1.2-3, 31A2-3, 31B1-3, 32A-C). Time of diagnosis defined as the time of the initial presenting radiograph and time of mobilization defined as the time the patient stood at edge of bed with physical therapy (PT) were determined. Average values before and after implementation of the HIP ATTACK protocol were compared using a student t-test with a p=0.05 set as the level of significance for each. A total of 781 patients were included in the analysis. There were 395 patients who had surgery prior to September 2016 (average age 79 years (range 50-102 years), 267 females and 187 males), and 386 patients who were operated on after HIP ATTACK implementation (average age 77 years (range 50-102 years), 232 females and 95 males). Compared to prior years, implementation of HIP ATTACK was associated with decreased time from diagnosis to surgery by an average of eight hours (30 vs 22 hours, p<0.0001) and decreased time from surgery to PT evaluation by an average of three hours (30 vs 27 hours, p=0.049). Time from surgery to mobilization was not significantly different before and after HIP ATTACK implementation (59 vs 58 hours, p=0.63). Implementation of the standardized HIP ATTACK protocol by a multidisciplinary team was associated with improvement in time to surgery and PT evaluation. A standardized, multidisciplinary protocol can minimize delay in caring for patients with hip fractures and is critical in limiting morbidity and mortality. 2.

Delirium is a common perioperative complication among older adults undergoing surgery for hip fractures. It is associated with increased risks of recurrent fractures, prosthesis-related complications, such as loosening, breakage, or dislocation, and overall delayed recovery. The etiology of delirium is multifactorial, involving intrinsic and precipitating factors spanning physiological, psychological, and environmental domains. Quality control circle (QCC) activities, defined as collaborative, problem-solving initiatives led by teams with shared or complementary responsibilities, are designed to promote continuous improvements in healthcare quality. The aim of this pilot study is to evaluate the effectiveness of QCC-based interventions in reducing the incidence of perioperative delirium among older adults with hip fractures. A double-blinded pilot study was conducted involving 90 older adults diagnosed with hip fractures between April 2022 and September 2023. Participants were assigned to either a control group (n = 46), receiving standard delirium management, or an intervention group (n = 44), which received additional QCC-based care strategies. Interventions included early mobilization, optimization of sleep duration and quality, cognitive and orientation support, and targeted delirium education for both patients and caregivers. Outcomes compared between groups included the incidence and duration of perioperative delirium, night-time sleep duration, and sleep quality index. The incidence of perioperative delirium was lower in the intervention group (9.0%) compared to the control group (17.4%). The duration of delirium episodes was significantly shorter in the intervention group (p < 0.001). In addition, the intervention group demonstrated significantly longer nocturnal sleep durations (p < 0.001) and higher sleep quality index scores (p < 0.001) compared to the control group. The integration of QCC-based interventions was associated with a reduced incidence and duration of perioperative delirium in older adults with hip fractures. Improvements in sleep quality and night-time sleep duration were observed, indicating that QCC activities may contribute to enhanced postoperative recovery in this population. However, these findings should be interpreted with caution given the relatively small sample size and single-center design.

Outcomes of nonagenarians undergoing hip fracture surgery: a multicentre observational study across Asia-Oceana.

Preoperative RDW-Based composite score for predicting mortality after hip fracture surgery.

The optimal timing of hip fracture surgery in patients with preoperative fever remains uncertain. Although early surgery generally improves outcomes, fever often prompts delays because of concerns about underlying infection. We retrospectively reviewed 208 patients (median age 83 years, 58% women) with low-energy hip fractures and documented preoperative fever (T > 38 °C) treated at a tertiary trauma center from 2012 to 2023. Patients were categorized by surgical timing: early (≤48 h, n = 108) or delayed (>48 h, n = 100). The primary outcome was one-year all-cause mortality, obtained from the national registry. Secondary outcomes were postoperative length of hospital stay and deep surgical site infection requiring surgical intervention. One-year mortality was 20.4% (22/108) in the early group and 31.0% (31/100) in the delayed group (p = 0.079). Median postoperative length of stay was shorter after early surgery (6 days, IQR 4-11) than after delayed surgery (9 days, IQR 5-14; p = 0.031). Deep surgical site infection occurred in 1/108 (0.9%) early patients and 4/100 (4.0%) delayed patients (p = 0.148). Patients selected for early surgery had fewer systemic signs of illness, including lower CRP levels, less desaturation, and less frequent bacterial infections-suggesting that clinical judgment influenced surgical timing. Among patients with confirmed bacterial etiology, early surgery did not increase deep surgical site infection rates or one-year mortality compared to delayed surgery. Early surgery in febrile hip fracture patients may be safe when guided by individualized assessment. Our findings support developing structured clinical criteria to aid surgical timing decisions, warranting further validation through larger prospective studies.

Peripheral nerve blocks (PNBs) are increasingly recommended as analgesia for hip fractures. Their association with outcomes beyond the immediate pharmacological effects remains unclear. This study examined the association between the use of PNBs and the number of days alive and at home after hip fracture surgery among Medicare beneficiaries. To examine the association between PNBs and long-term outcomes in older adults undergoing surgical fixation for hip fractures, we analyzed Medicare data from 2010 to 2018. Patients who received PNBs (exposure group) (n = 5701) were compared to those who did not receive a PNB (comparator group) using 1:1 propensity score matching, creating 5700 matched pairs. The primary outcome was days alive and at home within 120 days of admission. Secondary outcomes included days alive and at home within 365 days and 1-year mortality. A subgroup analysis of propensity score matched patients from 2018 examined outcomes when techniques had improved and use had increased. In the primary analysis (2010-2018), no significant differences were observed between groups for days alive and at home within 120 days (68.1 vs. 68.4 days; p = 0.64), days alive and at home within 365 days (244.5 vs. 240.7 days; p = 0.12), or 1-year mortality (21% vs. 22%; p = 0.22). In 2017 and 2018, when peripheral nerve block use increased, patients who received PNBs spent more days alive and at home within 365 days than patients who did not receive peripheral nerve blocks (248.6 vs. 241.6 days; p = 0.04). PNBs showed no association with improved outcomes across the 2010-2018 study period. Analysis of 2017 and 2018 revealed more days alive and at home within 365 days and a trend toward reduced mortality among patients who received PNBs. PNBs may provide benefits beyond their immediate analgesic effects, potentially improving long-term outcomes.

BackgroundAs the older adults population grows, the incidence of hip fractures continues to rise, presenting a major challenge to healthcare systems. Traditional postoperative rehabilitation often struggles with continuity and accessibility, particularly for patients in remote areas. Telerehabilitation, which leverages digital technologies for remote care, is emerging as a potential solution to overcome these limitations and provide more efficient, accessible rehabilitation for older adult patients recovering from hip fractures.ObjectiveTo conduct a scoping review of studies on the application of telerehabilitation in home care for older adults postoperative hip fractures, aiming to evaluate its effectiveness, methods, and potential for standardization in clinical practice.MethodsBased on scoping review guidelines, a systematic search was conducted on CNKI, Wanfang Database, CQVIP, CBM, PubMed, Web of Science, Cochrane Library, CINAHL, and Embase, up to August 31, 2025..The included literature was summarized and analyzed.ResultsA total of 18 studies were included. Among these, mobile applications, WeChat platforms, and video interaction systems were the primary methods for home-based care of elderly patients after hip fracture surgery, all utilizing telerehabilitation delivered through video, text, and image-based interventions. A meta-analysis of key outcome measures revealed significant improvements in the telerehabilitation group compared to the control group across several domains: hip function (HHS, P < 0.001), walking ability (6MWT, P < 0.0001), and quality of life (SF-36, P < 0.001). Furthermore, advantages were noted in pain relief (NPRS, P < 0.05) and a reduction in depressive symptoms (HADS-D, P = 0.003). Notably, multiple studies consistently reported significantly higher exercise adherence in the telerehabilitation group compared to the control group (P < 0.05).ConclusionTelerehabilitation effectively enhances functional recovery and adherence in older adults after hip fracture surgery. Its success depends on matching interventions to patients’ digital literacy. Future implementation requires standardized protocols and outcome measures to be integrated into professional follow-up care, thereby overcoming existing barriers and maximizing scalability.Trial registrationOSF Registration DOI: https://doi.org/10.17605/OSF.IO/QYUJM

Analgesic and Functional Outcomes of Ultrasound-Guided Pericapsular Nerve Group (PENG), Fascia Iliaca, and Femoral Nerve Blocks in Hip Fracture Surgery: A Randomized Controlled Trial

Sensory processing impairments and their associations with physical and psychological outcomes in older adults after fall-related hip fracture surgery: a prospective cross-sectional study.

The global aging population has led to a significant increase in hip fractures among elderly patients, posing substantial clinical challenges. While early surgical intervention is widely advocated, its impact on postoperative complications and mortality in super-aged (≥ 80 years) hip fracture patients remains controversial. This study aimed to evaluate the association between early surgery and clinical outcomes in this population. We conducted a retrospective cohort study of patients aged ≥ 80 years who underwent hip fracture surgery at a single-center orthopedic trauma center between January 2018 and November 2021. Participants were stratified into early surgery (≤ 48 h post-admission) and non-early surgery groups. Propensity score matching (PSM) was employed to control for confounding variables. Primary outcomes included 30-day, 90-day, 1-year, and 2-year mortality rates. Secondary outcomes encompassed perioperative transfusion rates, postoperative complications, hospital length of stay (LOS), and hospitalization costs. After PSM, a total of 300 patients were included. Compared with the non-early surgery group, the early surgery group had lower 1-year (11.6% vs. 28.0%, p < 0.001) and 2-year (36.0% vs. 50.7%, p = 0.010) postoperative mortality rates, a lower perioperative blood transfusion rate (32.7% vs. 53.3%, p < 0.001), lower incidences of postoperative pneumonia (15.3% vs. 29.3%, p = 0.004) and delirium (14.0% vs. 36.0%, p < 0.001), a shorter length of stay [8.6 days (7.5, 11.2) vs. 11.6 days (9.7, 14.9), p < 0.001], and lower hospitalization expenses [54,336 ¥ (48,965, 64,532) vs. 61,616 ¥ (50,758, 74,484), p = 0.001]. The serum albumin level at discharge in the early surgery group was higher (33.4 (31.6, 35.4) vs. 32.6 (30.7, 34.9), p = 0.039). Kaplan-Meier survival curve analysis showed that the all-cause mortality rate in the non-early surgery group increased (Log Rank p = 0.0066). Multivariate Cox analysis showed that age, BMI, admission hemoglobin, and non-early surgery were risk factors for 2-year mortality. Early surgical intervention for hip fractures in super-aged patients is associated with improved survival, reduced complications, and better resource utilization. These findings support the implementation of protocols to minimize preoperative delays in this vulnerable population.

The hemoglobin-to-red cell distribution width ratio (HRR), which has demonstrated better predictive ability than the red blood cell distribution width (RDW) and hemoglobin (Hb) level, has not been used to predict orthopedic surgical outcomes and may be a novel prognostic parameter for mortality. In this single-center cohort study, data of 363 patients (aged ≥60 years) who underwent surgery for fragility hip fracture at our institution between January 2016 and December 2018 were retrospectively analyzed. Multivariable Cox proportional hazards and Kaplan-Meier survival curve analyses were performed to compare the high and low HRR and RDW groups, divided based on cutoff values. The power of mortality prediction over time was assessed by comparing Harrell's concordance index using the bootstrapping method. Among 363 patients, the overall mortality was 48.48% (176/363), with a mean±standard deviation of 4.31±2.09 (0.02-7.44) years. HRR was significantly associated with all-cause mortality after hip fracture surgery (hazard ratio: 0.989; 95% confidence interval: 0.978-0.999; p=0.044). Moreover, during the follow-up period after 1 year, HRR demonstrated the second-highest predictive ability for mortality among all laboratory parameters and indicators reflecting general condition, and it remained unaffected by anemia status for up to 4 years. HRR is proposed as a novel prognostic indicator for mid- to long-term survival after hip fracture surgery in older patients.

Emerging evidence suggests that inflammatory and immune biomarkers may serve as prognostic indicators across diverse clinical contexts. This study sought to investigate the association between the high-sensitivity C-reactive protein to lymphocyte ratio (hs-CLR) and the risk of postoperative delirium in elderly patients undergoing surgery for hip fractures. We conducted a retrospective cohort study of patients aged 60 years or older who underwent surgical management for hip fractures at a university-affiliated tertiary hospital between January 2021 and December 2024. The primary exposure was hs-CLR, and the primary endpoint was 30-day postoperative delirium, ascertained through systematic review of inpatient medical records and confirmed by outpatient and telephone follow-up. The relationship between hs-CLR and delirium was explored using restricted cubic spline modeling, receiver operating characteristic curve analysis, univariate comparisons, and multivariate logistic regression. A total of 582 patients (192 males, 390 females; mean age 73.8 ± 8.4 years) were included. The 30-day incidence of delirium was 21.3% (124/582). Both unadjusted and adjusted restricted cubic spline analyses revealed a significant nonlinear dose-response association between hs-CLR and delirium risk (P <.05). Using a clinically determined threshold of 36.0, patients were stratified into low and high hs-CLR groups. Patients with elevated hs-CLR were more often male, had a higher comorbidity burden (reflected by higher age-adjusted Charlson comorbidity index and American Society of Anesthesiologists class) and poorer nutritional and general health status (lower serum albumin, red blood cell count, and serum sodium) than those with low hs-CLR. Multivariable logistic regression demonstrated that hs-CLR ≥36.0 was independently associated with increased odds of postoperative delirium (fully adjusted model: odds ratio 2.35, 95% CI 1.47–3.74; backward elimination model: odds ratio 2.28, 95% CI 1.46–3.54). This study delineates a robust nonlinear association between elevated hs-CLR and the risk of postoperative delirium in elderly hip fracture patients, and establishes that hs-CLR ≥36.0 is independently associated with delirium. These findings underscore the potential value of incorporating hs-CLR into preoperative risk stratification to enhance perioperative management in this vulnerable population.

Abstract Introduction Hip fractures in older adults often lead to prolonged disability and reduced quality of life. While baseline physical health is a known predictor of recovery following hip fracture, the underlying causal mechanisms remain poorly understood. There is growing interest in the influence psychosocial factors—for example, psychological resilience—have on recovery. This study examines the relationship between baseline psychological resilience and 12-month recovery of functional outcomes following hip fracture surgery in older patients. Methods A 12-month, multi-centre pilot cohort study was conducted with 125 adults aged ≥50 years, hospitalised for hip fracture. A final analytical sample of 86 participants (mean age 72.5 years) was analysed for longitudinal outcomes. Baseline psychological resilience (measured by CD-RISC10) and physical health (handgrip strength) were assessed during acute hospitalisation. The primary outcome was functional outcomes at 12-months, measured using the Modified Barthel Index, Parker Mobility Score and SF-36 Questionnaire (Physical Function). Mixed-effects regression models evaluated the association between baseline resilience and functional recovery over time. Causal mediation analysis was performed to assess whether resilience mediated the effect of baseline physical function on recovery. Results Resilience was directly associated with improved physical function in the 12 months following hip fracture surgery. Resilience partially mediated the relationship between baseline physical health and recovery of mobility, and recovery of self-rated physical health. Respectively, resilience mediated 22.5% of the total effect between baseline physical health and mobility after 12-months, and 23.6% of the total effect between baseline physical health and self-rated physical health after 12-months. Resilience was a complete mediator of the relationship between baseline physical health and recovery of independence when performing activities of daily living, mediating 24.0% of the total effect. Conclusions These findings suggest that enhancing psychological resilience may be an effective strategy for improving recovery outcomes among older post-operative hip fracture patients, alongside traditional physical rehabilitation.

Abstract Introduction Early mobilisation following hip fracture surgery is a key determinant of better health outcomes and reduced mortality. However, high levels of postoperative pain and inconsistent analgesia administration were noted as barriers to mobilisation on our dedicated femoral fracture unit. This quality improvement project aimed to understand pain and analgesia on the unit, and in doing so, target better pain relief to improve outcomes through optimised engagement with therapy. Methods Baseline data were collected on 26 post-operative patients to assess subjective pain scores (or Abbey Pain Scale where appropriate), pre-operative prescribing bundle adherence, and administration of PRN analgesia. Semi-structured interviews with ward nurses and therapy staff explored barriers to effective pain management and access to PRN analgesia. Using Model for Improvement methodology multiple Plan-Do-Study-Act (PDSA) cycles were undertaken, including a test of change to trial use of a buprenorphine patch, staff education to target prescribing behaviours and nursing workflow optimisation. Results Initial data showed 30% of patients reported pain ≥8/10 on day one, with poor correlation between pain scores and PRN analgesia administered. Qualitative data revealed key barriers included staff workload, controlled drug (CD) access delays, poor interprofessional communication, and hesitancy around use of stronger opioids. Introduction of a one-off buprenorphine patch resulted in a 20% reduction in day one pain and a 23% reduction on day two. The highest reported pain was 7/10 (vs 10/10 pre-intervention). No significant increase in postoperative delirium was noted. However, PRN administration remained inconsistent despite improvements in pre-op analgesia bundle prescribing and communication strategies. Conclusion This multifaceted, multidisciplinary quality improvement project has provided valuable insight into understanding pain and analgesia on the hip fracture unit. The project has highlighted focus areas for strategies to reduce postoperative pain. However further work is required to address persistent barriers to PRN analgesia administration and promote sustained prescribing behaviours.

Abstract Background Hip fractures represent a significant global health burden, leading to substantial morbidity, mortality, and healthcare costs. Delays in surgical intervention are consistently linked to poorer patient outcomes. This audit aimed to evaluate and enhance hip fracture management at Southampton General Hospital (SGH) through targeted quality improvement initiatives. Methods An interventional clinical audit was conducted at SGH, a Major Trauma Centre, comparing a pre-intervention period (December 2023—March 2024; n = 272 patients) with a post-intervention period (September 2024—December 2024; n = 291 patients). The methodology adhered to NICE guidelines. Data were collected via consecutive sampling from the National Hip Fracture Database (NHFD), Pathpoint eTrauma, and CHARTS/EDMS. Interventions focused on increasing surgical capacity (e.g. additional theatre allocation, dedicated hip fracture team), implementing comprehensive multidisciplinary medical evaluation, optimising imaging, addressing pre-existing conditions, standardising anticoagulation reversal, and improving overall patient care. Mean operating times, 30-day mortality rates, and length of hospital stay (LOS) were assessed and compared between cycles. Results The overall average patient age was 84 years. In the pre-intervention cycle, the mean operating time was 80 hours, with a 30-day mortality rate of 4.7%. Surgical delays affected 57.4% of patients. Post-intervention, the mean operating time significantly decreased to 55 hours, and the 30-day mortality rate reduced to 3.0%, notably lower than the national average of 5.9% for the same period. Despite these improvements, the proportion of delayed surgeries increased slightly to 63.9%. A key finding was that in the post-intervention cycle, an equal number of patients (n = 6) died in both the non-delayed (5.7%) and delayed (3.2%) groups, suggesting that enhanced medical optimisation during delays contributed to improved outcomes. Delays consistently correlated with prolonged LOS in both cycles. Conclusion Targeted quality improvement initiatives at SGH significantly reduced the average time to hip fracture surgery and improved overall mortality rates. The crucial role of comprehensive medical stabilisation in mitigating mortality risks, even when leading to surgical delays, was evident. Despite systemic challenges inherent to a major trauma centre, these interventions demonstrate a positive impact on patient outcomes. Ongoing efforts should focus on sustainable theatre capacity, streamlined diagnostic pathways, and continuous auditing to optimise patient care.

The optimal threshold to blood transfusion in patients after hip fracture surgery is unclear. This study leveraged regression discontinuity to quantify blood transfusion practices across haemoglobin thresholds of 7.0, 8.0, and 10.0 g/dL. This study used the enhanced claims-based Premier Inc. database and included inpatients, aged 50+, with an ICD-10 code for hip fracture and hip surgery, and at least one haemoglobin following surgery. For each patient-day following surgery, we determined the lowest haemoglobin level and whether blood transfusion was administered. Regression discontinuity (RD) models with local linear regression were used to calculate risk differences, mean differences, and 95% confidence intervals (CIs) for blood transfusion use. There were 320,194 patient-days (among 93,111 patients) included in analyses. Transfusion occurred on 29,425 patient-days (9.2%). The median haemoglobin on patient-days with a transfusion was 7.0 (interquartile range [IQR] 6.7-7.6) g/dL and the median haemoglobin on patient-days without a transfusion was 9.3 (IQR 8.4-10.4) g/dL. There was a statistically significant increase in transfusion use crossing a haemoglobin threshold of 7.0 g/dL (19.0; 95% CI, 13.5-22.5 absolute percentage points) and a small, statistically significant increase in transfusion use crossing an 8.0 g/dL haemoglobin threshold. (3.2; 95% CI, 0.9-6.2 absolute percentage points). There was no discontinuity in transfusion use across a haemoglobin concentration threshold of 10.0 g/dL (-0.2; 95% CI -0.7-0.3 absolute percentage points). After hip fracture surgery, transfusion based on a haemoglobin threshold of 7.0 g/dL was more common than at guideline recommended 8.0 g/dL or at the liberal threshold of 10 g/dL.

Early postoperative walking recovery using a connected bodyweight-supported treadmill after hip fracture surgery in older patients: a retrospective cohort study (STAND-UP).