Dülgeroğlu Turan Cihan, Kurt Mehmet, Üzümcigil Alaaddin Oktar, Yilmaz Selçuk, Karaaslan Fatih
Department of Orthopedics and Traumatology, Kütahya Health Sciences University Faculty of Medicine, 43020 Kütahya, Turkey.
Department of Orthopedics and Traumatology, Memorial Hospital, 38000 Kayseri, Turkey.
Exp Ther Med. 2024 Aug 30;28(5):414. doi: 10.3892/etm.2024.12703. eCollection 2024 Nov.
The present retrospective cross-sectional study aimed to evaluate the predictive value of blood parameters and ratios for predicting mortality in patients with hip fractures. In total, 758 patients with hip fractures attending the Department of Orthopedics and Traumatology, Kütahya Health Sciences University Faculty of Medicine (Kütahya, Turkey) between January 2016 and January 2023 were included in the present study. Patients were then divided into two groups, namely the mortality (n=464; 61.2%) and survivor (n=294; 38.8%) groups. Patients in the mortality group were further sub-divided into the following three subgroups: i) Those who succumbed in <1 month (n=117; 25.2%); ii) those who succumbed between 1 and 12 months (n=185; 39.9%); and iii) those who succumbed >12 months later (n=162; 34.9%). In addition, the RDW coefficient of variation, mean platelet volume (MPV), MPV/platelet ratio, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio and monocyte-to-eosinophil ratio means were all found to be significantly higher in the mortality group (P<0.05). MPV (P<0.01), HGB (P<0.05), eosinophil, EOS (P<0.01), HRR (P<0.01), and PLR (P<0.05) were all revealed to exert significant effects on mortality. An age cut-off of 74.50 years had a sensitivity of 81.5% and specificity of 37.1%, whereas an MPV cut-off of 8.85 yielded a sensitivity of 73.5% and specificity of 36.1%. By contrast, an HGB cutoff of 11.05 had a sensitivity of 55.6% and specificity of 35.7%, an eosinophil cut-off of 0.065 had a sensitivity of 47.6% and specificity of 35.4%, whilst a HRR cut-off of 0.7587 had a sensitivity of 55.2% and specificity of 30.3%. Furthermore, a PLR cut-off of 152.620 had a sensitivity of 67.2% and specificity of 41.8% for hip fracture-associated mortality. An age cut-off of 79.50 years had a sensitivity of 70.9% and specificity of 41.5%, while an age cut-off of 83.50 years had a sensitivity of 46.2% and specificity of 64.0% for mortality occurring <1 month after hip fractures. To conclude, results from the present study suggested that HRR has potential predictive value for hip fracture-associated mortality and 30-day mortality, whereas the PLR could only predict hip fracture-associated mortality.
本回顾性横断面研究旨在评估血液参数及比值对预测髋部骨折患者死亡率的价值。2016年1月至2023年1月期间,土耳其屈塔希亚健康科学大学医学院骨科收治的758例髋部骨折患者纳入本研究。患者随后被分为两组,即死亡组(n = 464;61.2%)和存活组(n = 294;38.8%)。死亡组患者进一步细分为以下三个亚组:i)在<1个月内死亡者(n = 117;25.2%);ii)在1至12个月内死亡者(n = 185;39.9%);iii)在>12个月后死亡者(n = 162;34.9%)。此外,发现死亡组的红细胞分布宽度变异系数、平均血小板体积(MPV)、MPV/血小板比值、中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值、血小板与淋巴细胞比值(PLR)、平均血小板体积与淋巴细胞比值及单核细胞与嗜酸性粒细胞比值均值均显著更高(P<0.05)。MPV(P<0.01)、血红蛋白(HGB,P<0.05)、嗜酸性粒细胞(EOS,P<0.01)、心率恢复率(HRR,P<0.01)及PLR(P<0.05)均对死亡率有显著影响。年龄临界值74.50岁时,敏感性为81.5%,特异性为37.1%;而MPV临界值8.85时,敏感性为73.5%,特异性为36.1%。相比之下,HGB临界值11.05时,敏感性为55.6%,特异性为35.7%;嗜酸性粒细胞临界值0.065时,敏感性为47.6%,特异性为35.4%;HRR临界值0.7587时,敏感性为55.2%,特异性为30.3%。此外,PLR临界值152.620对髋部骨折相关死亡率的敏感性为67.2%,特异性为41.8%。年龄临界值79.50岁时,敏感性为70.9%,特异性为41.5%;年龄临界值83.50岁时,对髋部骨折后<1个月内发生的死亡率敏感性为46.2%,特异性为64.0%。总之,本研究结果表明,HRR对髋部骨折相关死亡率及30天死亡率具有潜在预测价值,而PLR仅能预测髋部骨折相关死亡率。