284 frail, elderly patients who sustained a hip fracture and experienced post-operative anemia following either internal fixation or total hip arthroplasty were randomly assigned to receive either a restrictive (Hb <9.7 g/dL) or liberal (Hb <11.3 g/dL) blood transfusion protocol. The purpose of this study was to compare overall quality of life (OQoL) and ability to perform activities of daily life (ADL) at follow-up points of 30 days and 1 year, to determine if transfusion protocol and hemoglobin levels had a significant impact on rehabilitation and recovery outcomes. Results indicated that the two groups did not significantly differ overall self-assessed quality of life, however, liberal transfusion protocl may provide an advantage for recovery of the ability to perform activities of daily life.