Predictive Value of Blood Parameters and Comorbidities on Three-Month Mortality in Elderly Patients With Hip Fracture

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2021 Nov 12

PMID 34765379

Citations 5

Authors

Esra Demirel

Ali Sahin

Affiliations

Soon will be listed here.

Abstract

Background Knowing the factors that increase the risk of death in patients with hip fractures will help us to take precautions and intervene when necessary in the pre- and postoperative periods. Therefore, it is important to have inexpensive and practical biomarkers that can predict postoperative complications and mortality. The present study aimed to identify the factors that contribute to early mortality in elderly patients with hip fractures in the first three months after trauma, as well as the parameters that may be determinants of mortality. Methods The data of 1,015 patients over 65 years of age with femoral neck and intertrochanteric fractures admitted between January 2009 and January 2020 were retrospectively reviewed. A total of 763 patients who met the inclusion criteria were included in the study. Our study was designed to include 110 (14.4%) patients in Group 1 who were determined to have died within three months after the diagnosis of hip fracture and 653 (85.6%) patients in Group 2 who were determined not to have died within one year after the trauma. Age, gender, comorbid diseases, American Society of Anesthesiologists (ASA) score, type of anesthesia, operation time, type of implant used, time until surgery, and some biochemical blood values were compared between the two groups. Our data were analyzed statistically using the IBM Statistical Product and Service Solutions (SPSS) software for Windows, v. 25.0 (IBM SPSS Statistics for Windows, Armonk, NY). Results Of all of the patients, 370 (48.5%) were female and 393 (51.5%) were male. The patients who survived had an average age of 76.08, while the patients who died had an average age of 80.57. The mean age among the groups is significantly higher in patients who died. High creatinine, alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and low albumin values were found to be associated with mortality. Conclusion It has been determined that advanced age, delayed operation time, high ASA score, and the number of comorbid diseases are associated with mortality in elderly patients with hip fractures, and biomarkers, such as creatinine, ALT, and LDH, can be used as markers for early mortality. With the increase of studies of similar nature, it will be possible to calculate a systematic risk map for mortality in elderly patients with a proximal femur fracture.

Citing Articles

The association between preoperative serum cholinesterase and all-cause mortality in geriatric patients with hip fractures: a cohort study of 2387 patients.

Zhang Y, Xiao P, Zhang B Perioper Med (Lond). 2024; 13(1):82.

PMID: 39049017 PMC: 11267686. DOI: 10.1186/s13741-024-00443-2.

Association of Serum Lactate Levels Measured in the Emergency Department with 30-Day Mortality in Older Patients with Unilateral Hip Fractures.

Ozen Olcay H, Emektar E, Saral Ozturk Z, Akkan S, Cevik Y Ann Geriatr Med Res. 2024; 28(3):301-306.

PMID: 38952335 PMC: 11467522. DOI: 10.4235/agmr.24.0011.

Influencing factors on morbidity and mortality in intertrochanteric fractures.

Babagoli M, Ghaseminejad Raeini A, Sheykhvatan M, Baghdadi S, Shafiei S Sci Rep. 2023; 13(1):12090.

PMID: 37495718 PMC: 10372085. DOI: 10.1038/s41598-023-38667-9.

The association between hemoglobin at admission and mortality of older patients with hip fracture: a mean 3-year follow-up cohort study.

Zhang B, Wang J, Wen P, Wu Y, Guo J, Wang Y Eur Geriatr Med. 2023; 14(2):275-284.

PMID: 36805525 DOI: 10.1007/s41999-023-00759-0.

Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture.

Fisher A, Srikusalanukul W, Fisher L, Smith P J Clin Med. 2022; 11(22).

PMID: 36431261 PMC: 9696473. DOI: 10.3390/jcm11226784.

References

Aslan A, Atay T, Aydogan N . Risk factors for mortality and survival rates in elderly patients undergoing hemiarthroplasty for hip fracture. Acta Orthop Traumatol Turc. 2020; 54(2):138-143. PMC: 7286162. DOI: 10.5152/j.aott.2020.02.298. View

Lopez-Velazquez J, Chavez-Tapia N, Ponciano-Rodriguez G, Sanchez-Valle V, Caldwell S, Uribe M . Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure: an important prognostic indicator. Ann Hepatol. 2014; 13(1):98-104. View

Aldebeyan S, Nooh A, Aoude A, Weber M, Harvey E . Hypoalbuminaemia-a marker of malnutrition and predictor of postoperative complications and mortality after hip fractures. Injury. 2017; 48(2):436-440. DOI: 10.1016/j.injury.2016.12.016. View

Venkatesan M, Smith R, Balasubramanian S, Khan A, Uzoigwe C, Coats T . Serum lactate as a marker of mortality in patients with hip fracture: A prospective study. Injury. 2015; 46(11):2201-5. DOI: 10.1016/j.injury.2015.06.038. View

Forasassi C, Golmard J, Pautas E, Piette F, Myara I, Raynaud-Simon A . Inflammation and disability as risk factors for mortality in elderly acute care patients. Arch Gerontol Geriatr. 2008; 48(3):406-10. DOI: 10.1016/j.archger.2008.03.011. View

Mangat K, Mehra A, Yunas I, Nightingale P, Porter K . Is estimated peri-operative glomerular filtration rate associated with post-operative mortality in fractured neck of femur patients?. Injury. 2008; 39(10):1141-6. DOI: 10.1016/j.injury.2008.02.034. View

Samura T, Yoshioka D, Toda K, Sakaniwa R, Shimizu M, Miyagawa S . Risk of stroke early after implantation of a left ventricular assist device. J Thorac Cardiovasc Surg. 2018; 157(1):259-267.e1. DOI: 10.1016/j.jtcvs.2018.06.031. View

Johnell O, Kanis J . An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int. 2004; 15(11):897-902. DOI: 10.1007/s00198-004-1627-0. View

Fisher L, Srikusalanukul W, Fisher A, Smith P . Liver function parameters in hip fracture patients: relations to age, adipokines, comorbidities and outcomes. Int J Med Sci. 2015; 12(2):100-15. PMC: 4293175. DOI: 10.7150/ijms.10696. View

10.

Lewis J, Hassan S, Wenn R, Moran C . Mortality and serum urea and electrolytes on admission for hip fracture patients. Injury. 2006; 37(8):698-704. DOI: 10.1016/j.injury.2006.04.121. View

11.

Forget P, Moreau N, Engel H, Cornu O, Boland B, De Kock M . The neutrophil-to-lymphocyte ratio (NLR) after surgery for hip fracture (HF). Arch Gerontol Geriatr. 2014; 60(2):366-71. DOI: 10.1016/j.archger.2014.11.008. View

12.

Symeonidis P, Clark D . Assessment of malnutrition in hip fracture patients: effects on surgical delay, hospital stay and mortality. Acta Orthop Belg. 2006; 72(4):420-7. View

13.

Roche J, Wenn R, Sahota O, Moran C . Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005; 331(7529):1374. PMC: 1309645. DOI: 10.1136/bmj.38643.663843.55. View

14.

Frost S, Nguyen N, Black D, Eisman J, Nguyen T . Risk factors for in-hospital post-hip fracture mortality. Bone. 2011; 49(3):553-8. DOI: 10.1016/j.bone.2011.06.002. View

15.

Hu F, Jiang C, Shen J, Tang P, Wang Y . Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2011; 43(6):676-85. DOI: 10.1016/j.injury.2011.05.017. View

16.

Bjorkelund K, Hommel A, Thorngren K, Lundberg D, Larsson S . Factors at admission associated with 4 months outcome in elderly patients with hip fracture. AANA J. 2009; 77(1):49-58. View

17.

Shiga T, Wajima Z, Ohe Y . Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression. Can J Anaesth. 2008; 55(3):146-54. DOI: 10.1007/BF03016088. View

18.

Heslin M, Brennan M . Advances in perioperative nutrition: cancer. World J Surg. 2001; 24(12):1477-85. DOI: 10.1007/s002680010265. View

19.

Seyedi H, Mahdian M, Khosravi G, Bidgoli M, Mousavi S, Razavizadeh M . Prediction of mortality in hip fracture patients: role of routine blood tests. Arch Bone Jt Surg. 2015; 3(1):51-5. PMC: 4322126. View

20.

Fisher A, Fisher L, Srikusalanukul W, Smith P . Usefulness of simple biomarkers at admission as independent indicators and predictors of in-hospital mortality in older hip fracture patients. Injury. 2018; 49(4):829-840. DOI: 10.1016/j.injury.2018.03.005. View