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The other two patients were on regular aspirin and despite having a preoperative haemoglobin level above 10?g/dL, dropped their postoperative haemoglobin below 7?g/dL. A haemoglobin concentration of 10?g/dL or more is a generally accepted safe threshold for elective or semi-elective surgery.10?and?26 Ninety seven percent of patients in this study were above the safe haemoglobin threshold for surgery according to their level on admission but only 79% had that level preoperatively according to the repeat test (Table 2). The patients were given fluid as per local hip fracture protocol (1?l of fluid every 8?h). Most patients with hip fracture are dehydrated on admission and [http://www.selleckchem.com/products/abt-199.html Venetoclax] intravenous fluid is given to restore their hydration. Their oral intake remains minimal prior to surgery unless it is unduly delayed. Average daily intake of fluid for a healthy adult is between 2 and 3?l.18 Grathwohl et al found no difference in haemoglobin or haematocrit during maintenance fluid treatments.15 In presence of normal renal function, minimal oral intake and a degree of pre-existing dehydration, the likelihood of dilution with an infusion protocol allowing only 3?l of fluid in 24?h should be negligible. During this study, 15 patients were prevented from going to theatre with a haemoglobin level [http://www.selleckchem.com/products/MDV3100.html Enzalutamide datasheet] to theatre on the basis of their on admission haemoglobin and in all likelihood would have had a dangerously [http://www.selleck.cn/products/SB-431542.html SB431542] low postoperative haemoglobin level. Their postoperative haemoglobin with perioperative blood transfusion was better than the predicted haemoglobin without blood transfusion (Table 3). Postoperative drowsiness, lethargy and tachycardia could be attributed to anaesthesia, analgesia and/or pain. Anaemia is diagnosed by postoperative full blood count commonly performed the day after surgery and therefore its correction may be delayed by 24�C48?h following its onset, if a repeat blood sample is not sent following re-hydration. This delay may allow enough time for complications to occur. Foss and Kehlet noted postoperative anaemia to be associated with higher medical complications and increased length of stay despite the liberal transfusion threshold enforced in their regimen.14 We believe their patients may have had low haemoglobin levels for a prolonged period before diagnosis and correction. Most patients with a fracture of neck of femur are elderly and although the basal function of various organ systems may be relatively uncompromised, the functional reserve and the ability to compensate for physiologic stress are reduced.4 A postoperative haemoglobin of less than 8?g/dL has been associated with increased morbidity and the odds of death increases 2.5 times for each gram decrease in haemoglobin below this level.