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 language | English |
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Article number | 183 |
Pages (from-to) | 183 |
Journal | Anesthesiology |
Volume | 18 |
Issue number | 1 |
DOIs | |
Publication status | Published - 3 Dec 2018 |
Externally published | Yes |
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