Prediction of postoperative mortality in elderly patient with hip fractures: a single-centre, retrospective cohort study

Romain Niessen, Benoit Bihin, Maximilien Gourdin, Jean-Cyr Yombi, Olivier Cornu, Patrice Forget

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable.

METHODS: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D0) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models.

RESULTS: No correlation between gender, age, NLR D0 or CRP D0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance.

CONCLUSIONS: Neither age, gender, NLR D0 nor CRP D0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.

Original languageEnglish
Article number183
Pages (from-to)183
JournalAnesthesiology
Volume18
Issue number1
DOIs
Publication statusPublished - 3 Dec 2018
Externally publishedYes

Keywords

  • Biomarkers
  • C-reactive protein
  • Frailty
  • Hip fractures
  • Hospital mortality
  • Multivariate Analysis
  • Prognosis
  • Age Factors
  • Humans
  • Lymphocytes/metabolism
  • Male
  • Postoperative Complications/epidemiology
  • Aged, 80 and over
  • Female
  • Retrospective Studies
  • Hip Fractures/surgery
  • Neutrophils/metabolism
  • Reproducibility of Results
  • Hospital Mortality
  • Risk Factors
  • Linear Models
  • Sex Factors
  • Aged
  • C-Reactive Protein/metabolism
  • Cohort Studies

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