6/28/23, 10:39 PM FOCUS Pathway Feedback Search Clinical Topics Home Studies FOCUS FOCUS Disease Hip fracture Trial question What is the role of liberal transfusion strategy in high-risk patients after hip surgery? Study design Multi-center Open label RCT Population Characteristics of study participants 76.0% female N = 2016 24.0% male 2016 patients (1527 female, 489 male) Inclusion criteria: patients 50 years of age with a history of or risk factors for CVD who had Hgb level < 10 g/dL after hip-fracture surgery Key exclusion criteria: unable to walk without human assistance before hip fracture, declined blood transfusions, had multiple trauma, pathologic hip fracture associated with cancer, history of clinically recognized acute myocardial infarction within 30 days before randomization, or actively bleeding at the time of potential randomization Interventions N=1007 liberal use of transfusions (a Hgb threshold of 10 g/dL) N=1009 restrictive use of transfusion (symptoms of anemia or at physician discretion for a Hgb level of < 8 g/dL) Primary outcome Death or an inability to walk across a room without human assistance at 60 days https://web.pathway.md/studies/recaSL8g5CJvdGXAU 1/2 6/28/23, 10:39 PM FOCUS Pathway 35.2 % 35.2 34.7 26.4 % 17.6 % 8.8 % No significant difference 0.0 % Liberal use of transfusions Restrictive use of transfusion No significant difference in death or an inability to walk across a room without human assistance at 60 days (35.2% vs. 34.7%; OR 1.01, 95% CI 0.84 to 1.22) Secondary outcomes No significant difference in in-hospital acute coronary syndrome or death (4.3% vs. 5.2%; OR 0.82, 99% CI 0.48 to 1.42) No significant difference in death at 60 days (7.6% vs. 6.6%; OR 1.17, 99% CI 0.75 to 1.83) Safety outcomes No significant difference in serious adverse events and in-hospital clinical events. Conclusion In patients 50 years of age with a history of or risk factors for CVD who had Hgb level < 10 g/dL after hip-fracture surgery, liberal use of transfusions were not superior to restrictive use of transfusion with respect to death or an inability to walk across a room without human assistance at 60 days. Reference Carson JL, Terrin ML, Noveck H et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011 Dec 29;365(26):2453-62. Open reference URL https://web.pathway.md/studies/recaSL8g5CJvdGXAU 2/2