入院时前白蛋白浓度与老年髋部骨折患者死亡率的关系：一项队列研究。
The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study.
机构信息
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Beilin District, No. 555 Youyi East Road, Xi'an, 710054, Shaanxi Province, China.
出版信息
Arch Osteoporos. 2024 Apr 11;19(1):27. doi: 10.1007/s11657-024-01384-5.
UNLABELLED
Malnutrition is associated with complications and mortality in patients of hip fracture. Prealbumin may be more suitable than albumin to accurately predict the prognosis of hip fracture in elderly patients. We found that prealbumin concentration was nonlinearly associated with mortality in elderly patients with hip fracture, and an inflection point effect was observed.
OBJECTIVE
To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures.
METHODS
Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between prealbumin concentration at admission and mortality. All analyses were performed using EmpowerStats and the R software.
RESULTS
This cohort study included 2387 patients who met the study criteria. The mean follow-up was 37.64 months. The prealbumin concentration was 162.67 ± 43.2 mg/L. Multivariate Cox regression showed that prealbumin concentration was associated with mortality in geriatric patients with hip fracture (hazard ratio [HR] = 0.95, 95% confidence intervals [CI]: 0.93-0.97, P < 0.0001). In addition, an inflection point effect was observed in the nonlinear association. The inflection point was 162.2 mg/L. If it is less than this inflection point, then every 10 mg/L increase in prealbumin was associated with a 7% reduction in the risk of death (HR = 0.93, 95%CI: 0.90-0.96, P < 0.0001). When greater than the inflection point, there was no difference in the risk of death (HR = 0.99, 95%CI: 0.95-1.03, P = 0.5127).
CONCLUSION
The prealbumin concentrations at admission were nonlinearly associated with long-term mortality in geriatric hip fractures, and 162.2 mg/L could be considered a prognostic factor of mortality risk.
不具名
营养不良与髋部骨折患者的并发症和死亡率有关。前白蛋白可能比白蛋白更适合准确预测老年髋部骨折患者的预后。我们发现，老年髋部骨折患者的前白蛋白浓度与死亡率呈非线性相关，并观察到拐点效应。
目的
评估入院时前白蛋白浓度与老年髋部骨折患者死亡率的关系。
方法
筛选 2015 年 1 月至 2019 年 9 月期间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 回归模型来确定入院时前白蛋白浓度与死亡率之间的关系。所有分析均使用 EmpowerStats 和 R 软件进行。
结果
本队列研究纳入了 2387 名符合研究标准的患者。平均随访时间为 37.64 个月。前白蛋白浓度为 162.67 ± 43.2mg/L。多变量 Cox 回归显示，前白蛋白浓度与老年髋部骨折患者的死亡率相关（风险比[HR] = 0.95，95%置信区间[CI]：0.93-0.97，P < 0.0001）。此外，在非线性关联中观察到拐点效应。拐点为 162.2mg/L。如果低于该拐点，则前白蛋白每增加 10mg/L，死亡风险降低 7%（HR = 0.93，95%CI：0.90-0.96，P < 0.0001）。如果高于拐点，则死亡风险没有差异（HR = 0.99，95%CI：0.95-1.03，P = 0.5127）。
结论
入院时的前白蛋白浓度与老年髋部骨折患者的长期死亡率呈非线性相关，162.2mg/L 可被视为死亡率风险的预后因素。
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