营养和炎症指标能预测脆性髋部骨折患者90天的死亡率吗?

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2023-01-01 Epub Date: 2023-10-30 DOI:10.1051/sicotj/2023029
Tal Frenkel Rutenberg, Avital Hershkovitz, Rana Jabareen, Maria Vitenberg, Efrat Daglan, Moti Iflah, Michael Drexler, Shai Shemesh
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引用次数: 0

摘要

引言:老年人髋部骨折与死亡率增加有关。识别有风险的患者至关重要。研究了几种营养和炎症参数,以寻找脆性髋关节骨折(FHF)手术后死亡率的预后指标。我们的目的是评估它们的效用,并在不同因素之间进行比较。方法:对2012年1月至2020年6月期间接受脆性髋关节骨折手术的65岁及以上患者进行回顾性队列研究。根据年龄、性别、骨折类型和合并症,将90天内死亡的患者与存活对照组按1:1的比例进行匹配。比较各组间的营养和炎症指标,包括血清白蛋白、蛋白质能量营养不良(PEM)、白蛋白与球蛋白比率(AGR)、预后营养指数(PNI)、全身免疫炎症指数(SII)、血小板与淋巴细胞比率(PLR)和中性粒细胞与淋巴细胞比率。结果:纳入304例患者,每组152例。患者的人口统计数据相似。在所有评估的指标中,只有研究组之间的PLR有显著差异(研究组为236.9±193.5,对照组为186.6±119.3(p=0.007)。在首次住院后存活的患者中,PEM也与90天死亡率相关。讨论:PLR被发现与FHF手术后的死亡率相关。由于它可以很容易地从可获得的血液测试中计算出来,我们建议将其“常规评估”作为对高死亡率患者进行个性化管理的筛查工具。
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Can nutritional and inflammatory indices predict 90-day mortality in fragility hip fracture patients?

Introduction: Hip fractures in the elderly are related to increased mortality. The identification of patients at risk is essential. Several nutritional and inflammatory parameters were investigated in an effort to find a prognostic indicator for mortality following fragility hip fractures (FHF) surgery. We aim to evaluate their utility and compare between the different factors.

Methods: A retrospective cohort study of patients 65 years and older, who underwent surgery following fragility hip fractures between January 2012 and June 2020, was conducted. Patients who died within 90 days were matched at a 1:1 ratio with surviving controls, based on age, gender, fracture type, and comorbidities. Nutritional and inflammatory indices, including serum albumin, protein energy malnutrition (PEM), albumin-to-globulin ratio (AGR), prognostic nutritional index (PNI), the systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and the neutrophile-to-lymphocyte ratio (NLR), were compared between groups.

Results: 304 patients were included, 152 in each group. Patients' demographics were similar. Among all indices evaluated, only the PLR significantly differed between the study groups (236.9 ± 193.5 for the study group vs. 186.6 ± 119.3 for the control group (p = 0.007). In patients who survived the initial hospitalization, the PEM was also found to be correlated with 90 days mortality.

Discussion: The PLR was found to be correlated with mortality risk following FHF surgery. As it can be easily calculated from accessible blood tests, we recommend its' routine assessment as a screening tool for personalized management of patients at high risk for mortality.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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