Department of Orthopedics, Zigong First People's Hospital, Zigong, China.
Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China.
BMC Musculoskelet Disord. 2024 Mar 25;25(1):234. doi: 10.1186/s12891-024-07336-x.
This study aimed to evaluate the correlation admission albumin levels and 30-day readmission after hip fracture surgery in geriatric patients.
In this retrospective cohort study, 1270 geriatric patients admitted for hip fractures to a level I trauma center were included. Patients were stratified by clinical thresholds and albumin level quartiles. The association between admission albumin levels and 30-day readmission risk was assessed using multivariate logistic regression and propensity score-matched analyses. The predictive accuracy of albumin levels for readmission was evaluated by ROC curves. The dose-response relationship between albumin levels and readmission risk was examined.
The incidence of 30-day readmission was significantly higher among hypoalbuminemia patients than those with normal albumin levels (OR = 2.090, 95%CI:1.296-3.370, p = 0.003). Furthermore, propensity score-matched analyses demonstrated that patients in the Q2(35.0-37.9 g/L) (OR 0.621, 95%CI 0.370-1.041, p = 0.070), Q3(38.0-40.9 g/L) (OR 0.378, 95%CI 0.199-0.717, p < 0.001) and Q4 (≥ 41 g/L) (OR 0.465, 95%CI 0.211-0.859, p = 0.047) quartiles had a significantly lower risk of 30-day readmission compared to those in the Q1(< 35 g/L) quartile. These associations remained significant after propensity score matching (PSM) and subgroup analyses. Dose-response relationships between albumin levels and 30-day readmission were observed.
Lower admission albumin levels were independently associated with higher 30-day readmission rates in elderly hip fracture patients. Our findings indicate that serum albumin may assist perioperative risk assessment, and prompt correction of hypoalbuminemia and malnutrition could reduce short-term readmissions after hip fracture surgery in this high-risk population.
本研究旨在评估老年髋部骨折患者入院时白蛋白水平与术后 30 天再入院的相关性。
本回顾性队列研究纳入了在 I 级创伤中心因髋部骨折入院的 1270 名老年患者。根据临床阈值和白蛋白水平四分位数对患者进行分层。使用多变量逻辑回归和倾向评分匹配分析评估入院时白蛋白水平与 30 天再入院风险之间的关联。通过 ROC 曲线评估白蛋白水平对再入院的预测准确性。还检验了白蛋白水平与再入院风险之间的剂量反应关系。
低白蛋白血症患者的 30 天再入院发生率明显高于白蛋白正常水平患者（OR=2.090，95%CI：1.296-3.370，p=0.003）。此外，倾向评分匹配分析表明，Q2（35.0-37.9 g/L）（OR 0.621，95%CI 0.370-1.041，p=0.070）、Q3（38.0-40.9 g/L）（OR 0.378，95%CI 0.199-0.717，p<0.001）和 Q4（≥41 g/L）（OR 0.465，95%CI 0.211-0.859，p=0.047）四分位数的患者 30 天再入院风险显著低于 Q1（<35 g/L）四分位数患者。这些关联在倾向评分匹配（PSM）和亚组分析后仍然显著。还观察到白蛋白水平与 30 天再入院之间的剂量反应关系。
入院时较低的白蛋白水平与老年髋部骨折患者较高的 30 天再入院率独立相关。我们的研究结果表明，血清白蛋白可能有助于围手术期风险评估，并且在该高危人群中，髋部骨折手术后及时纠正低白蛋白血症和营养不良可能会降低短期再入院率。
