葡萄糖-白蛋白比值（GAR）作为老年髋部骨折患者术后尿路感染的一种新型生物标志物。
Glucose-albumin ratio (GAR) as a novel biomarker of postoperative urinary tract infection in elderly hip fracture patients.
作者信息
Wang Wei, Tang Wanyun, Yao Wei, Lv Qiaomei, Ding Wenbo
机构信息
Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China.
Department of Oncology, Dandong Central Hospital, China Medical University, Dandong, China.
出版信息
Front Med (Lausanne). 2024 Jul 15;11:1366012. doi: 10.3389/fmed.2024.1366012. eCollection 2024.
PURPOSE
Postoperative urinary tract infections (UTIs) worsen the prognosis of elderly patients with hip fractures. This study aimed to assess the predictive ability of blood-based biomarkers, specifically the glucose-albumin ratio (GAR), in predicting postoperative UTIs.
METHODS
A retrospective observational study of 1,231 patients from a Level I trauma center was conducted. We evaluated the prognostic and predictive value of 15 biomarkers, including the glucose-albumin ratio, in elderly patients with hip fractures. The primary outcome measure was the incidence of postoperative UTIs.
RESULTS
The glucose to albumin ratio transformed into GAR was superior to any other biomarker in predicting postoperative UTIs in elderly hip fracture patients (AUC = 0.756, < 0.001). Elevated GAR (using the best cut-off value of 0.18) was independently associated with postoperative UTIs (OR 3.20, 95% CI 2.23-4.58). Further analysis dividing GAR levels into four groups according to quartiles showed that compared to patients with GAR levels of Q1 (< 0.14), GAR levels of Q2 (0.14-0.17; OR 2.11, 95% CI 1.07-4.15), Q3 (0.17-0.21; OR 3.36, 95% CI 1.74-6.52) and Q4 (> 0.21; OR 7.55, 95% CI 3.84-14.83) patients had significantly higher odds of UTIs.
CONCLUSION
GAR holds potential as a novel biomarker for predicting postoperative UTIs in elderly patients with hip fractures.
目的
术后尿路感染（UTIs）会使老年髋部骨折患者的预后恶化。本研究旨在评估基于血液的生物标志物，特别是糖白蛋白比（GAR），对术后UTIs的预测能力。
方法
对来自一级创伤中心的1231例患者进行了一项回顾性观察研究。我们评估了15种生物标志物（包括糖白蛋白比）对老年髋部骨折患者的预后和预测价值。主要结局指标是术后UTIs的发生率。
结果
转化为GAR的血糖与白蛋白比在预测老年髋部骨折患者术后UTIs方面优于任何其他生物标志物（AUC = 0.756，<0.001）。GAR升高（使用最佳截断值0.18）与术后UTIs独立相关（OR 3.20，95%CI 2.23 - 4.58）。根据四分位数将GAR水平分为四组的进一步分析表明，与GAR水平处于Q1（<0.14）的患者相比，GAR水平处于Q2（0.14 - 0.17；OR 2.11，95%CI 1.07 - 4.15）、Q3（0.17 - 0.21；OR 3.36，95%CI 1.74 - 6.52）和Q4（>0.21；OR 7.55，95%CI 3.84 - 14.83）的患者发生UTIs的几率显著更高。
结论
GAR有望成为预测老年髋部骨折患者术后UTIs的新型生物标志物。
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