Rutenberg Tal Frenkel, Hershkovitz Avital, Jabareen Rana, Vitenberg Maria, Daglan Efrat, Iflah Moti, Drexler Michael, Shemesh Shai
Department of Orthopaedic Surgery, Rabin Medical Center, 39 Jabotinsky st., Petach Tikva 4941492, Israel - Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6423906, Israel.
Beit Rivka Geriatric Rehabilitation Center, 4 Ha Hamisha st., Petach Tikva 4924577, Israel and Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6423906, Israel.
SICOT J. 2023;9:30. doi: 10.1051/sicotj/2023029. Epub 2023 Oct 30.
Hip fractures in the elderly are related to increased mortality. The identification of patients at risk is essential. Several nutritional and inflammatory parameters were investigated in an effort to find a prognostic indicator for mortality following fragility hip fractures (FHF) surgery. We aim to evaluate their utility and compare between the different factors.
A retrospective cohort study of patients 65 years and older, who underwent surgery following fragility hip fractures between January 2012 and June 2020, was conducted. Patients who died within 90 days were matched at a 1:1 ratio with surviving controls, based on age, gender, fracture type, and comorbidities. Nutritional and inflammatory indices, including serum albumin, protein energy malnutrition (PEM), albumin-to-globulin ratio (AGR), prognostic nutritional index (PNI), the systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and the neutrophile-to-lymphocyte ratio (NLR), were compared between groups.
304 patients were included, 152 in each group. Patients' demographics were similar. Among all indices evaluated, only the PLR significantly differed between the study groups (236.9 ± 193.5 for the study group vs. 186.6 ± 119.3 for the control group (p = 0.007). In patients who survived the initial hospitalization, the PEM was also found to be correlated with 90 days mortality.
The PLR was found to be correlated with mortality risk following FHF surgery. As it can be easily calculated from accessible blood tests, we recommend its' routine assessment as a screening tool for personalized management of patients at high risk for mortality.
老年人髋部骨折与死亡率增加有关。识别高危患者至关重要。研究了几个营养和炎症参数，以寻找脆性髋部骨折（FHF）手术后死亡率的预后指标。我们旨在评估它们的效用并比较不同因素。
对2012年1月至2020年6月期间因脆性髋部骨折接受手术的65岁及以上患者进行了一项回顾性队列研究。根据年龄、性别、骨折类型和合并症，将在90天内死亡的患者与存活对照以1:1的比例进行匹配。比较了两组之间的营养和炎症指标，包括血清白蛋白、蛋白质能量营养不良（PEM）、白蛋白与球蛋白比率（AGR）、预后营养指数（PNI）、全身免疫炎症指数（SII）、血小板与淋巴细胞比率（PLR）和中性粒细胞与淋巴细胞比率（NLR）。
纳入304例患者，每组152例。患者的人口统计学特征相似。在所有评估指标中，只有PLR在研究组之间存在显著差异（研究组为236.9±193.5，对照组为186.6±119.3（p = 0.007）。在初次住院存活的患者中，还发现PEM与90天死亡率相关。
发现PLR与FHF手术后的死亡风险相关。由于它可以通过可获取的血液检测轻松计算得出，我们建议将其作为高危死亡患者个性化管理的筛查工具进行常规评估。
