Department of Orthopaedic Surgery, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark.
Injury. 2012 Jul;43(7):1014-20. doi: 10.1016/j.injury.2011.12.008. Epub 2012 Jan 10.
The aim of this study was to assess the evidence for the association between different biochemical markers at admission and mortality through a meta-analysis.
PubMed-, Embase-, Cochran Library and the Web of Knowledge were searched for cohort studies.
Eligible studies were observational studies with a study population larger than 150 subjects, a mean age above 60 years and a study duration below 730 days.
Characteristics of studies and outcomes of all-cause mortality were extracted from the retrieved articles. Data were pooled across studies for the individual biomarker using random- or fixed-effect analysis.
15 eligible studies of 5 different markers on mortality were studied. The following markers were found to be of prognostic value on mortality in hip fracture patients: low haemoglobin (odds ratio, 2.78; 95% confidence interval, 2.17-3.55; P<0.00001, 3148 subjects included), low total lymphocyte count, TLC (odds ratio, 2.60; 95% confidence interval, 1.61-4.20; P<0.00001, 1689 subjects included), low albumin (odds ratio, 1.83; 95% confidence interval, 1.31-2.56; P=0.0004, 1680 subjects included), low albumin/low TLC (odds ratio, 3.00; 95% confidence interval, 1.81-4.99; P<0.0001, 704 subjects included), low albumin/high TLC (odds ratio, 3.39; 95% confidence interval, 1.83-6.29; P=0.0001, 704 subjects included), high creatinine (odds ratio, 1.58; 95% confidence interval, 1.25-1.99; P=0.0001, 3761 subjects included), and high PTH (odds ratio, 15.43; 95% confidence interval, 3.60-66.14; P=0.0002, 525 subjects included).
Biochemical markers at admission are valid predictors of mortality in hip fracture patients.
本研究旨在通过荟萃分析评估入院时不同生化标志物与死亡率之间的关联证据。
在 PubMed、Embase、Cochrane 图书馆和 Web of Knowledge 中检索队列研究。
符合条件的研究为观察性研究，研究人群大于 150 例，平均年龄大于 60 岁，研究持续时间小于 730 天。
从检索到的文章中提取研究特征和全因死亡率结果。使用随机或固定效应分析对个体生物标志物的数据进行汇总。
研究了 5 种不同标志物对死亡率的 15 项符合条件的研究。结果发现，以下标志物对髋部骨折患者的死亡率具有预后价值：低血红蛋白（优势比，2.78；95%置信区间，2.17-3.55；P<0.00001，包括 3148 例）、低总淋巴细胞计数（TLC）（优势比，2.60；95%置信区间，1.61-4.20；P<0.0001，包括 1689 例）、低白蛋白（优势比，1.83；95%置信区间，1.31-2.56；P=0.0004，包括 1680 例）、低白蛋白/低 TLC（优势比，3.00；95%置信区间，1.81-4.99；P<0.0001，包括 704 例）、低白蛋白/高 TLC（优势比，3.39；95%置信区间，1.83-6.29；P=0.0001，包括 704 例）、高肌酐（优势比，1.58；95%置信区间，1.25-1.99；P=0.0001，包括 3761 例）和高甲状旁腺激素（PTH）（优势比，15.43；95%置信区间，3.60-66.14；P=0.0002，包括 525 例）。
入院时的生化标志物是髋部骨折患者死亡率的有效预测指标。
