Ding Kai, Shang Zeyu, Sun Dacheng, Yang Weijie, Zhang Yifan, Wang Ling, Zhang Tao, Du Xiaofeng, Dai Yajiang, Zhu Yanbin, Chen Wei
Department of Orthopaedic Surgery, Hebei Orthopaedic Clinical Research Center, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, People's Republic of China.
Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institute of Hebei Province, Hebei, People's Republic of China.
Int Orthop. 2025 Jan;49(1):19-28. doi: 10.1007/s00264-024-06353-8. Epub 2024 Oct 28.
Immune response plays an important role in the regulation of elderly hip fracture. This study aims to analyze the relationship between systemic inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) and mortality and walking independence, providing valuable references for the postoperative management of geriatric hip fracture.
A retrospective analysis of prospective data on elderly patients who have undergone hip surgery and have been followed for at least one year. The receiver operating characteristic (ROC) curves and the optimum cutoff value were calculated. Univariate analysis and multivariate logistic regression analysis were used to identify the associations between admission four systemic inflammatory markers and one-year mortality and locomotion recovery.
During the study period, respiratory disease was the most common cause of death, followed by cardiovascular disease. Multivariate analysis identified NLR (OR, 1.13; 95%CI: 1.09-1.17), SIRI(OR, 1.18; 95%CI: 1.08-1.28) and advanced age (OR, 1.06; 95%CI: 1.01-1.11) as independent risk factors for one-year mortality. In addition, 89 (rate, 31.8%) survivors had poor walking independence within one year. NLR (OR, 1.37; 95%CI: 1.26-1.50), SII(OR, 1.00; 95%CI: 1.001-1.003), SIRI(OR, 1.36; 95%CI: 1.18-1.57) and advanced age (OR, 1.08; 95%CI: 1.02-1.13) were associated with postoperative locomotion recovery.
In summary, admission NLR and SIRI are correlated with a high risk of one-year walking independence and mortality, providing a basis for the clinical management of geriatric hip fractures.
免疫反应在老年髋部骨折的调节中起重要作用。本研究旨在分析包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)和全身炎症反应指数(SIRI)在内的全身炎症标志物与死亡率及步行独立性之间的关系,为老年髋部骨折的术后管理提供有价值的参考。
对接受髋部手术并随访至少一年的老年患者的前瞻性数据进行回顾性分析。计算受试者工作特征(ROC)曲线和最佳截断值。采用单因素分析和多因素逻辑回归分析来确定入院时的四种全身炎症标志物与一年死亡率及运动恢复之间的关联。
在研究期间,呼吸系统疾病是最常见的死亡原因,其次是心血管疾病。多因素分析确定NLR(比值比[OR],1.13;95%置信区间[CI]:1.09 - 1.17)、SIRI(OR,1.18;95%CI:1.08 - 1.28)和高龄(OR,1.06;95%CI:1.01 - 1.11)是一年死亡率的独立危险因素。此外,89名(比例,31.8%)幸存者在一年内步行独立性较差。NLR(OR,1.37;95%CI:1.26 - 1.50)、SII(OR,1.00;95%CI:1.001 - 1.003)、SIRI(OR,1.36;95%CI:1.18 - 1.57)和高龄(OR,1.08;95%CI:1.02 - 1.13)与术后运动恢复相关。
总之,入院时的NLR和SIRI与一年步行独立性差和死亡率高相关,为老年髋部骨折的临床管理提供了依据。