The authors reviewed data from 317 (out of a cohort of 344) patients over the age of 65 undergoing hip fracture surgery at their institution. They found that higher postoperative hemoglobin levels were associated with a shorter length of stay. The problem here is that, apparently, there were no strict criteria for hospital discharge and that the results simply reflect standard practice, i.e. physicians may have been biased towards a later discharge in anemic patients. The randomized FOCUS trial (Carson JL et al, N Engl J Med 2011;365:2453-62) shows that a restrictive transfusion strategy is not associated with prolonged discharge times.

– Jean-François Hardy