Postoperative delirium and myocardial infarction in elderly patients with hip fractures: the role of postoperative anemia

Objective. To assess the impact of anemia on the incidence of myocardial infarction and delirium in the early postoperative period in patients with hip fractures who underwent total hip replacement. Materials and methods. A retrospective study of 303 patients with hip fractures who underwent total hip replacement was performed. Patients were divided into two groups according to the level of hemoglobin (Hb) on the 2nd postoperative day: Group 1 (n = 116) with Hb levels above 100 g/L and Group 2 (n = 187) with Hb levels below 100 g/L. Results and conclusion. Transfusion in Group 1 was performed more often intraoperatively or in the early postoperative hours (67 vs. 35 patients; p <0.001). Hb levels on the 2nd day were significantly higher in Group 1 (108 [104; 117] vs. 87 [80; 92] g/L; p <0.001). Moderate and severe anemia in the early postoperative period was noted in 53.5% and 4.3% of the patients of Group 2, respectively. The incidence of myocardial infarction and delirium was higher in Group 2 than in Group 1 (6.4% vs. 0%; p = 0,013 and 7.5% vs 0.8%; p = 0.021, respectively). The study has shown that moderate and severe anemia in the early postoperative period is associated with an increase in the incidence of myocardial infarction and delirium.