Altın Emine Dizem Sunal, Canbolat Nur, Buget Mehmet I, Altın Yekta Furkan, Bayram Serkan, Koltka Kemalettin
Department of Anesthesiology and Reanimation, Istanbul Faculty of Medicine, Istanbul University, Turgut Ozal Millet Cd, 34093, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
J Anesth. 2025 Apr;39(2):205-214. doi: 10.1007/s00540-024-03444-z. Epub 2024 Dec 15.
Given the occurrence of comorbidities in geriatric patients, the postoperative period of hip fractures may progress with high morbidity and mortality. Recently, several inflammatory markers have been used to evaluate the treatment course. Herein, we prospectively followed-up and examined the relationship between preoperative fibrinogen/albumin ratio(FAR) and morbidity/mortality in elderly patients with hip fracture.
Patients aged ≥ 85 years who underwent hip fracture surgery under unilateral spinal anesthesia were included in this prospective observational study. The patients' preoperative FAR, age-adjusted Charlson comorbidity index(AACCI) score, Nottingham Hip Fracture Score, and Clinical Frailty Scale score were calculated. In addition, data on patients' morbidity, 3-month mortality, and lengths of intensive care unit (ICU) and hospital stay were recorded. The patients were categorized into two groups based on the FAR cutoff value of 0.102. A total of 108 patients participated in the study, with 43 assigned to Group 1(FAR < 0.102) and 65 to Group 2(FAR ≥ 0.102).
A significant difference was found in the risk of death within 3-months between patients with high and low FAR scores(p = 0.018). Patients with higher FAR scores were more likely to die within 3 months. A significantly positive association was observed between the FAR and AACCI score, with the AACCI score of Group2 being significantly higher than that of Group 1(p = 0.029). The lengths of hospital(p = 0.044) and ICU(p = 0.013) stay were significantly higher in Group2 than in Group1.
Preoperative FAR, which is an inexpensive and readily available test, is a promising index for predicting mortality and complications in patients with hip fracture.
鉴于老年患者合并症的发生情况，髋部骨折术后可能会出现高发病率和高死亡率。最近，几种炎症标志物已被用于评估治疗过程。在此，我们对老年髋部骨折患者术前纤维蛋白原/白蛋白比值（FAR）与发病率/死亡率之间的关系进行了前瞻性随访和研究。
本前瞻性观察性研究纳入了年龄≥85岁、在单侧脊髓麻醉下行髋部骨折手术的患者。计算患者术前的FAR、年龄校正的查尔森合并症指数（AACCI）评分、诺丁汉髋部骨折评分和临床衰弱量表评分。此外，记录患者的发病率、3个月死亡率以及重症监护病房（ICU）住院时间和住院总时长。根据FAR临界值0.102将患者分为两组。共有108例患者参与研究，其中43例被分配到第1组（FAR<0.102），65例被分配到第2组（FAR≥0.102）。
FAR评分高低的患者在3个月内的死亡风险存在显著差异（p=0.018）。FAR评分较高的患者在3个月内死亡的可能性更大。FAR与AACCI评分之间存在显著正相关，第2组的AACCI评分显著高于第1组（p=0.029）。第2组的住院时间（p=0.044）和ICU住院时间（p=0.013）均显著长于第1组。
术前FAR是一种廉价且易于获得的检测指标，是预测髋部骨折患者死亡率和并发症的一个有前景的指标。
