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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Anesthesiology 1/2014

Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial

BMC Anesthesiology > Ausgabe 1/2014
Kamilla Nielsen, Pär I Johansson, Benny Dahl, Michael Wagner, Britt Frausing, Jens Børglum, Kenneth Jensen, Jens Stürup, Jesper Hvolris, Lars S Rasmussen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2253-14-89) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KN, JB, KJ, MW and BF collected data. KN, BD, PIJ and LSR designed the research study. KN and LSR analyzed the data. All authors contributed to the writing of the manuscript. All authors read and approved the final manuscript.



Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision surgery.


The trial was registered at (NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation was assessed using Timed Up and Go-test (TUG) and ability to walk was also assessed daily by a physiotherapist blinded to the allocation.


Fifty-three patients were able to perform the TUG and included in the analysis. The TUG could be completed in a median of 36 sec vs. 30 sec in the restrictive group and the liberal group, respectively (P = 0.02). The mean difference in TUG was 14.5 sec (95% CI 2.8-26.2 sec). No difference was found in the day patients could perform TUG or walk 10 meters. The Hb at the day of testing was 10.2 g/dL in the restrictive group and 9.9 g/dL in the liberal group. Only 26 patients received RBC.


A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing.
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