Are Albumin and Total Lymphocyte Count Significant and Reliable Predictors of Mortality in Fractured Neck of Femur Patients?

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2013 Aug 31

PMID 23989803

Citations 8

Authors

Vishwajeet Kumar

Avinash Alva

Sudheer Akkena

Morgan Jones

Philip N Murphy

Tim Clough

Affiliations

Soon will be listed here.

Abstract

Hip fractures are a significant cause of mortality and morbidity in the elderly. It is important to identify factors that predict an increased mortality following hip fracture. The aim of this study was to identify significant predictors of mortality at 6 and 12 months following hip fractures. Three hundred patients above the age of 65 were identified who were admitted in to the hospital with fracture neck of femur. Two hundred and seventy-four patients were operated and were included into the study. Variables collected were age, gender, significant comorbidities, admission albumin level and admission total lymphocyte count (TLC). Admission time and subsequent time to surgery were also analysed. Our study showed that albumin and TLC were found to be the only clearly significant mortality predictors at 12 months and a delay of up to 4 days to surgery does not significantly increase the mortality at 12 months.

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References

van Zeeland M, Genovesi I, Mulder J, Strating P, Glas A, Engel A . POSSUM predicts hospital mortality and long-term survival in patients with hip fractures. J Trauma. 2011; 70(4):E67-72. DOI: 10.1097/TA.0b013e3181edbf7a. View

Gullberg B, Johnell O, Kanis J . World-wide projections for hip fracture. Osteoporos Int. 1997; 7(5):407-13. DOI: 10.1007/pl00004148. View

Siegmeth A, Gurusamy K, Parker M . Delay to surgery prolongs hospital stay in patients with fractures of the proximal femur. J Bone Joint Surg Br. 2005; 87(8):1123-6. DOI: 10.1302/0301-620X.87B8.16357. View

Maffulli N, Dougall T, Brown M, Golden M . Nutritional differences in patients with proximal femoral fractures. Age Ageing. 1999; 28(5):458-62. DOI: 10.1093/ageing/28.5.458. View

Kenzora J, McCarthy R, LOWELL J, Sledge C . Hip fracture mortality. Relation to age, treatment, preoperative illness, time of surgery, and complications. Clin Orthop Relat Res. 1984; (186):45-56. View

Papadimitropoulos E, Coyte P, Josse R, Greenwood C . Current and projected rates of hip fracture in Canada. CMAJ. 1997; 157(10):1357-63. PMC: 1228461. View

Koval K, Maurer S, Su E, Aharonoff G, Zuckerman J . The effects of nutritional status on outcome after hip fracture. J Orthop Trauma. 1999; 13(3):164-9. DOI: 10.1097/00005131-199903000-00003. View

Ponzer S, Tidermark J, Brismar K, Soderqvist A, Cederholm T . Nutritional status, insulin-like growth factor-1 and quality of life in elderly women with hip fractures. Clin Nutr. 1999; 18(4):241-6. DOI: 10.1016/s0261-5614(99)80076-4. View

Moran C, Wenn R, Sikand M, Taylor A . Early mortality after hip fracture: is delay before surgery important?. J Bone Joint Surg Am. 2005; 87(3):483-9. DOI: 10.2106/JBJS.D.01796. View

10.

Patterson B, CORNELL C, Carbone B, Levine B, Chapman D . Protein depletion and metabolic stress in elderly patients who have a fracture of the hip. J Bone Joint Surg Am. 1992; 74(2):251-60. View

11.

Maxwell M, Moran C, Moppett I . Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth. 2008; 101(4):511-7. DOI: 10.1093/bja/aen236. View

12.

Bergeron E, Lavoie A, Moore L, Bamvita J, Ratte S, Gravel C . Is the delay to surgery for isolated hip fracture predictive of outcome in efficient systems?. J Trauma. 2006; 60(4):753-7. DOI: 10.1097/01.ta.0000214649.53190.2a. View

13.

Lee H, Chang Y, Jean Y, Wang H . Importance of serum albumin level in the preoperative tests conducted in elderly patients with hip fracture. Injury. 2009; 40(7):756-9. DOI: 10.1016/j.injury.2009.01.008. View

14.

Kieffer W, Rennie C, Gandhe A . Preoperative albumin as a predictor of one-year mortality in patients with fractured neck of femur. Ann R Coll Surg Engl. 2013; 95(1):26-8. PMC: 3964632. DOI: 10.1308/003588413x13511609954815. View

15.

Klotzbuecher C, Ross P, Landsman P, Abbott 3rd T, Berger M . Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000; 15(4):721-39. DOI: 10.1359/jbmr.2000.15.4.721. View

16.

Lumbers M, New S, Gibson S, Murphy M . Nutritional status in elderly female hip fracture patients: comparison with an age-matched home living group attending day centres. Br J Nutr. 2001; 85(6):733-40. DOI: 10.1079/bjn2001350. View

17.

Cooper C, Campion G, Melton 3rd L . Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992; 2(6):285-9. DOI: 10.1007/BF01623184. View

18.

Sernbo I, Johnell O . Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int. 1993; 3(3):148-53. DOI: 10.1007/BF01623276. View

19.

Lefaivre K, Macadam S, Davidson D, Gandhi R, Chan H, Broekhuyse H . Length of stay, mortality, morbidity and delay to surgery in hip fractures. J Bone Joint Surg Br. 2009; 91(7):922-7. DOI: 10.1302/0301-620X.91B7.22446. View

20.

Dawe E, Lindisfarne E, Singh T, McFadyen I, Stott P . Sernbo score predicts survival after intracapsular hip fracture in the elderly. Ann R Coll Surg Engl. 2013; 95(1):29-33. PMC: 3964633. DOI: 10.1308/003588413X13511609954653. View