SHM Converge Scientific Abstract ePoster Gallery-Recombinant Human Erythropoietin in Jehova's Witnesses Patients With Hip Fracture

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This retrospective study described the management and outcomes of Jehovah’s Witnesses (JW) with hip fracture treated at a level I trauma center from January 2018 to June 2023. Because JW patients refuse blood products, the team evaluated recombinant human erythropoietin (rHuEPO) as a possible alternative to support recovery in bleeding-related trauma.<br /><br />The cohort included 10 elderly patients, mostly women, with a median age of 85 years. Hip fractures were mainly extracapsular. Comorbidity burden was high, with frequent polypharmacy, anticoagulation, and atrial fibrillation. Five patients received rHuEPO, usually 20,000 units subcutaneously per dose, with repeated doses given at least 2 days apart when needed and a target hemoglobin of 11 g/dL. All patients received IV iron and thromboprophylaxis; no transfusions were used.<br /><br />Medical complications were common. Acute kidney injury occurred in 4 of 10 patients, hypovolemic shock in 3, heart failure in 2, and thrombosis in 1. Patients who required rHuEPO had a greater hemoglobin drop than those who did not, with lower nadir hemoglobin levels and similar or lower discharge values, suggesting they were sicker and bled more. These patients also appeared to have more severe complications.<br /><br />Overall mortality was similar to what might be expected in this population, but JW patients with hip fracture experienced a high rate of medical complications and longer hospital stays. The authors conclude that strategies to reduce bleeding should begin immediately on admission. rHuEPO may be a useful option in selected JW patients, but further studies are needed to clarify its effectiveness and thrombotic risk.

Asset Subtitle

Nuria Rial Lorenzo

Meta Tag

Author List Adrian Puertas-Sanjuan, Antonio González-Fernández, Fernando Martínez-Valle, Isidro Sanz-Pérez, Jaume Mestre-Torres, Maria Urquizu-Padilla, Nuria Rial Lorenzo, Pau Carratalà-Marin, Pilar Lalueza-Broto

Category Research

Concept Jehovahs Witness

Concept Hip Fracture

Concept Erythropoietin

Concept Hemoglobin

Concept Blood Product Refusal

Distinguished Non-Finalist

Presenter Organization Internal Medicine, Hospital Vall d'Hebron

Presenting Author Nuria Rial Lorenzo

Track Perioperative

Keywords

Jehovah's Witnesses

hip fracture

retrospective study

recombinant human erythropoietin

rHuEPO

bloodless management

trauma center

elderly patients

hemoglobin drop

medical complications

Jehovahs Witness

Hip Fracture

Erythropoietin

Hemoglobin

Blood Product Refusal