Prognostic Role of Current Nutritional Indicators on Early and Late Postoperative Survival After Geriatric Hip Fracture Surgery

Abstract

Aim:Malnutrition is reported to be related to higher mortality rates following geriatric hip fracture, and new malnutrition indicators are currently being identified. The aim of this study is to analyze prognostic nutritional index (PNI), C-reactive protein (CRP)/albumin ratio (CAR) and CRPI/PNI ratio (CPR) as prognostic factors for first-month, six-month, one-year and overall mortality following hip fracture surgery.Methods:This study was designed as a cross-sectional study. We reviewed the medical records of patients older than 75 years with osteoporotic hip fracture surgery between January 2012 and October 2019. Preoperative serum albumin, total lymphocyte count, and CRP levels were evaluated as laboratory values. PNI, CAR, and CPR were calculated and analyzed as prognostic factors for mortality.Results:Four hundred and thirty patients were included in the study. High American Society of Anesthesiology (ASA) score (p=0.01) and admission to the intensive care unit (ICU) (p=0.016) were found to be independently associated with worse survival in the first month. The admission to the ICU (p=0.004) was independently related to poor survival in the first six months. High ASA score (p=0.018) and admission to the ICU (p=0.016) were independently associated with a poor survival in the first year. High ASA score (p<0.001) and admission to the ICU (p<0.001) were found to be independent prognostic factors for poor overall survival.Conclusion:PNI, CAR, and CPR were not significantly related to poor survival in the first month, six months, one year, and overall follow-up period after geriatric hip fracture surgery.

Keywords

• prognostic nutritional index
• c-reactive protein/prognostic nutritional index
• crp to albumin ratio
• mortality
• hip fracture
• elderly population