Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey.
Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey.
Injury. 2020 Nov;51(11):2663-2667. doi: 10.1016/j.injury.2020.07.048. Epub 2020 Jul 25.
Elderly patients with hip fractures exhibit a high incidence of mortality and morbidity. The aim of this study was to evaluate the factors that may predict mortality in patients with geriatric hip fracture.
Included in this retrospective study were 241 patients who were admitted to the hospital with hip fractures between May 2017 and March 2019. The effect of the modified 5-item frailty index (mFI-5) on 30-day and 1-year mortality was evaluated. In addition, admission neutrophil-to-lymphocyte ratios (NLRs) and monocyte-to-lymphocyte ratios (MLRs) were also examined.
The mFI-5 was not found to be a statistically significant predictive indicator for 30-day and 1-year mortality (P = 0.485 and P = 0.484, respectively). Chronic obstructive pulmonary disease or current pneumonia was found to increase mortality by 2.702 times (P = 0.002). The 30-day mortality rates of patients aged ≥80 years were significantly higher than those aged 65-79 years (P < 0.05). However, there was no statistical difference in the mortality rates between the age groups after 30 days postoperatively (P = 0.114). Admission NLRs and MLRs were significantly higher in the 30-day and 1-year mortality groups. The cut-off values of the admission NLRs and MLRs for 30-day mortality were calculated as 6.55 and 0.65, respectively, while the same cut-off values for 1-year mortality were calculated as 6.55 and 0.635, respectively.
Admission NLRs and MLRs are useful hematological data for the prediction of 30-day and 1-year mortality in geriatric hip fracture patients.
老年髋部骨折患者的死亡率和发病率较高。本研究旨在评估可能预测老年髋部骨折患者死亡率的因素。
本回顾性研究纳入 2017 年 5 月至 2019 年 3 月期间因髋部骨折住院的 241 名患者。评估改良的 5 项衰弱指数(mFI-5)对 30 天和 1 年死亡率的影响。此外,还检查了入院中性粒细胞与淋巴细胞比值(NLR)和单核细胞与淋巴细胞比值(MLR)。
mFI-5 与 30 天和 1 年死亡率均无统计学显著相关性(P=0.485 和 P=0.484)。慢性阻塞性肺疾病或现患肺炎使死亡率增加 2.702 倍(P=0.002)。年龄≥80 岁患者的 30 天死亡率明显高于 65-79 岁患者(P<0.05)。然而,术后 30 天后两组死亡率无统计学差异(P=0.114)。入院 NLR 和 MLR 在 30 天和 1 年死亡率组中均显著升高。入院 NLR 和 MLR 预测 30 天死亡率的截断值分别为 6.55 和 0.65,预测 1 年死亡率的截断值分别为 6.55 和 0.635。
入院 NLR 和 MLR 是预测老年髋部骨折患者 30 天和 1 年死亡率的有用血液学数据。