Impact of hematologic inflammatory markers on the prognosis of geriatric hip fracture: a systematic review and meta-analysis.

BACKGROUND

Geriatric hip fractures pose a significant health burden, and inflammation may play a role in the short- and long-term prognosis. However, the prognostic significance of hematologic inflammatory markers in geriatric patients with fractures is not understood. The aim of this systematic review and meta-analysis was to assess the prognostic implications of systemic inflammatory markers on the long-term mortality of older patients with hip fractures.

METHODS

PubMed, EMBASE, and Cochrane CENTRAL were searched from inception to December 19, 2023. Prospective, retrospective cohort, and case-control studies investigating the prognostic impact of hematologic inflammatory markers on mortality after hip fracture were eligible. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to determine the associations between the markers and mortality risk, with heterogeneity assessed by I statistic. The quality of the studies was appraised using the Newcastle-Ottawa Scale.

RESULTS

Ultimately, 7 retrospective studies involving a total of 7212 patients were included. The meta-analysis revealed that the neutrophil-to-lymphocyte ratio (NLR) (HR = 1.04, 95% CI 1.02-1.08), systemic immune-inflammatory index (SII) (HR = 1.03, 95% CI 1.01-1.05), and red cell distribution width (RDW) (HR = 1.07, 95% CI 1.01-1.14) independently correlated with increased long-term mortality.

CONCLUSIONS

Elevated NLR, SII, and RDW are independently associated with increased long-term mortality in older patients with hip fractures. These findings imply the potential value of incorporating these inflammatory indicators to aid in prognostic stratification of geriatric patients with hip fractures.