Title : HaemoCue: Does it change outcomes?
Abstract:
Neck Of Femur (NOF) fractures are a major contributor to trauma workload, particularly in older patients, where anaemia on admission is linked to complications and longer hospital stay. Rapid pre-operative haemoglobin assessment is therefore essential. HaemoCue, a point-of-care device, allows same-day haemoglobin testing but is not consistently used in practice.
We reviewed patients presenting with NOF fractures between August 2024 and January 2025. Exclusions included non-operative management, peri-prosthetic, and femoral shaft fractures. Data collected included demographics, fracture pattern, haemoglobin testing modality (HaemoCue, venous blood gas, full blood count), and transfusion requirements.
The audit standard was that all operative patients should undergo HaemoCue testing prior to surgery. Results showed low compliance with this standard. No significant predictors of mortality, complications, or length of stay were identified, although interpretation was limited by a small number of deaths (n=4). Mortality was higher among non-operative patients.
Our findings highlight that current practice falls short of recommended standards, with limited uptake of peri-operative HaemoCue testing. Improved integration of testing into the NOF pathway, potentially via the electronic patient record, could enhance compliance and data capture. Further research including rehabilitation length of stay may better define the role of peri-operative haemoglobin optimisation in this population.
