Frailty is Inversely Correlated with Preoperative Haemoglobin in Acute Hip Fracture Patients

Introduction:

Frailty is common in older patients with acute hip fractures. It has also been shown to be associated with poorer outcomes such as increased risk of infections, length of stay and increased 30-day mortality. Preoperative anaemia is also common in this cohort and is associated with adverse outcomes. 

Aims:

To assess the relationship between frailty and preoperative haemoglobin and to explore the effect of gender.

Methods:

A retrospective study of hospitalized acute hip fractures patients.  Anonymized data were extracted from the electronic notes of patients admitted from January to December of 2025 in a district general hospital in the UK. Patients were included if they were 60 years and older and had surgery for acute hip fracture. Patients with incomplete data were excluded from analysis. Rockwood’s Clinical Frailty Scale (CFS) was used to assess frailty. The IBM SPSS  30 was used for analysis of data.  Descriptive statistics was used for baseline characteristics.  Linear regression was used to assess correlation.

Results:

A total of 252 patients were analysed;178 females and 74 males.  Mean overall age was 81.9 (SD 8.59); females’ average age was 83.5 (SD 9.7) and males’ average age was 79.8 (SD 11.11). 

There was statistically significant inverse correlation between CFS and preoperative haemoglobin in all patients (r= -.202; p= .001); and female patients (r = -.181; p = .02); but a non-statistically significant correlation in male patients ( r= -.226; p =.051).

Conclusions:

Frailty is inversely correlated with preoperative haemoglobin in patients with acute hip fractures.  This correlation was statistically significant in female patients but was not statistically significant in male patients. This may have been due to smaller number of males in the sample. Larger studies are required to further explore these findings.