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Mortality after hip fracture in Japan: the role of nutritional status
Keita Miyanishi1, Seiya Jingushi, Takehiko Torisu
1Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Japan. keitam@major.ocn.ne.jp
Insights
Serum albumin and body mass index (BMI) predict 4-year mortality after hip fracture surgery. Lower levels of serum albumin and BMI are associated with increased mortality risk in Japanese patients.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Clinical Epidemiology
Background:
- Hip fractures are a significant cause of morbidity and mortality, particularly in elderly populations.
- Identifying predictive factors for mortality after hip fracture surgery is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate factors influencing 4-year mortality following hip fracture surgery.
- To assess the predictive value of various clinical parameters in a Japanese cohort.
Main Methods:
- Retrospective review of 129 hip fracture patients (24 men, 103 women) aged 50-103 years.
- Analysis of clinical data including BMI, serum albumin, comorbidities, and complications using logistic regression and ROC curves.
- Evaluation of 4-year mortality rates.
Main Results:
- The 4-year mortality rate was 48%.
- Serum albumin level (cut-off 36 g/l) and BMI (cut-off 18.9 kg/m²) were significant predictors of mortality.
- Patients with serum albumin <36 g/l or BMI <18.9 kg/m² had significantly worse survival rates.
Conclusions:
- Serum albumin level and BMI on admission are independent predictors of 4-year mortality after hip fracture surgery.
- These readily available parameters can aid in risk stratification and patient management.
Purpose:
To assess factors that influence 4-year mortality following hip fracture surgery in a Japanese population.
Methods:
Records of 129 hips in 24 men and 103 women aged 50 to 103 (mean, 79) years who underwent surgery for femoral neck or trochanteric fractures were reviewed. Clinical data reviewed included age, gender, body mass index (BMI), side of fracture, fracture type, fracture stability, surgery type, interval from admission to surgery, length of hospital stay, number of pre-fracture comorbidities, pre-fracture ambulatory level, pre-fracture place of residence, preoperative dementia, preoperative skeletal traction, blood haemoglobin level, serum albumin level, number of postoperative complications, and postoperative delirium. Univariate and multiple logistic regression analyses were performed to identify the relative contribution of the variables to mortality. Receiver operating characteristic (ROC) curves were used to identify optimal cut-off levels.
Results:
The 4-year mortality was 48%. Multiple logistic regression analysis showed that serum albumin level (p = 0.0004, odds ratio [OR] = 5.8541) and BMI (p = 0.0192, OR = 1.1693) significantly influenced mortality; the cut-off points were 36 g/l and 18.9 kg/m square, respectively, based on the ROC curves. Kaplan-Meier curves showed that survival rates were significantly worse in patients with values below these cut-off points.
Conclusion:
Serum albumin level and BMI on admission are predictive of mortality after hip fracture surgery.
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