School of Public Health, Xi'an Jiaotong University Health Science Center, No.76 Yanta West Road, Xi'an, 710061, Shaanxi Province, China.
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Arch Osteoporos. 2023 Jul 17;18(1):99. doi: 10.1007/s11657-023-01295-x.
Geriatric hip fracture patients often have increased N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels. This study found a curved association between preoperative NT-proBNP level and all-cause mortality. There was an inflection point of NT-proBNP 781 ng/L in the saturation effect. Thus, NT-proBNP was a valuable indicator of all-cause mortality.
To explore the relationship between N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level and all-cause mortality in geriatric hip fractures and evaluate the possible predictive role of NT-proBNP level.
Consecutive older adult patients with hip fractures were screened between January 2015 and September 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between NT-proBNP levels and mortality. All analyses were performed using EmpowerStats and the R software.
One thousand three hundred fifty-four patients were included in the study. The mean follow-up was 34.35 ± 15.82 months. Four hundred twenty-nine (31.68%) patients died due to all-cause mortality. The preoperative NT-proBNP was median 337.95 (range 16.09-20,123.00) ng/L. Multivariate Cox regression models showed a nonlinearity association between NT-proBNP levels and mortality in elderly hip fractures. An NT-proBNP of 781 ng/L was an inflection point in the saturation effect. When < 781 ng/L, NT-proBNP was associated with mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI]: 1.06-1.18, P < 0.0001), whereas at > 781 ng/L, NT-proBNP was not associated with mortality (HR = 1.00, 95% CI: 0.98-1.01, P = 0.4718). In the stratification analysis, the result was stable.
The NT-proBNP levels were nonlinearly associated with mortality in elderly hip fractures, and NT-proBNP of 781 ng/L was a valuable indicator of all-cause mortality.
ChiCTR2200057323.
探讨老年髋部骨折患者脑钠肽前体（NT-proBNP）水平与全因死亡率的关系，并评估 NT-proBNP 水平的可能预测作用。
筛选 2015 年 1 月至 2019 年 9 月期间连续的老年髋部骨折患者。收集患者的人口统计学和临床特征。使用线性和非线性多变量 Cox 回归模型来确定 NT-proBNP 水平与死亡率之间的关系。所有分析均使用 EmpowerStats 和 R 软件进行。
本研究纳入了 1354 名患者。平均随访时间为 34.35±15.82 个月。429 名（31.68%）患者因各种原因死亡。术前 NT-proBNP 的中位数为 337.95（范围 16.09-20123.00）ng/L。多变量 Cox 回归模型显示，老年髋部骨折患者的 NT-proBNP 水平与死亡率之间存在非线性关系。当 NT-proBNP 为 781ng/L 时，是饱和效应的拐点。当 <781ng/L 时，NT-proBNP 与死亡率相关（危险比[HR] = 1.12，95%置信区间[CI]：1.06-1.18，P<0.0001），而当 >781ng/L 时，NT-proBNP 与死亡率无关（HR=1.00，95%CI：0.98-1.01，P=0.4718）。在分层分析中，结果是稳定的。
NT-proBNP 水平与老年髋部骨折患者的死亡率呈非线性相关，NT-proBNP 为 781ng/L 是全因死亡率的一个有价值的指标。
ChiCTR2200057323。
