CRP/albumin ratio in predicting 1-year mortality in elderly patients undergoing hip fracture surgery

A. Aydın, O. Kaçmaz

Department of Anesthesiology and Reanimation, Faculty of Medicine, Malatya Turgut Özal University, Malatya Training and Research Hospital, Malatya, Turkey. ketamin2323@gmail.com

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• Orthopedics

OBJECTIVE: In the literature, rates of up to 37.1% have been reported for 1-year mortality after hip fractures. In this study, we aimed to determine whether the C-reactive protein/albumin ratio (CAR) is an independent risk factor for 1-year mortality after hip fracture and whether CAR, neutrophil/lymphocyte ratio (NLR), CRP, albumin level, and other parameters have an effect on mortality and morbidity.

PATIENTS AND METHODS: Over a 3-year period, 480 patients aged 65 years and older who underwent hemiarthroplasty for hip fracture were analyzed. A univariate logistic regression analysis was performed to identify prognostic factors for 1-year mortality. Significant variables were re-evaluated using binary logistic regression analysis.

RESULTS: The number of patients who died within 1 year postoperatively was 95 (27.7%), and the median age was 85 years. In the receiver operating characteristic analysis (ROC) for 1-year mortality after hip fracture, the optimal cut-off value of CAR was found to be 1.03. The area under the curve (AUC) for mortality was 0.843, the sensitivity was 65.3%, and the specificity was 92.7% [95% confidence interval (CI), 0.791-0.895; p < 0.001]. The optimal cut-off value for CRP was 2.85, the AUC was 0.838, the sensitivity was 70%, and the specificity was 89% (95% CI, 0.785-0.890; p < 0.001). The optimal cut-off value of NLR for postoperative intensive care unit (ICU) admission was determined to be 6.64.

CONCLUSIONS: CAR was a predictive factor for 1-year postoperative mortality and postoperative ICU admission, whereas NLR was a predictive factor for postoperative ICU admission.

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