Laboratory nutritional parameters predict one-year mortality in elderly patients with intertrochanteric fracture

The purpose of this study was to investigate the contributing value of nutrition related blood parameters to one-year mortality following intertrochanteric fracture surgery in a Chinese population over the age of 65.

Nutritional status was evaluated by using admission serum albumin and total lymphocyte count (TLC). One hundred and seventy-four intertrochanteric fracture patients were entered into this study for nutritional status assessment. Gender differences were evaluated by univariate analysis. The predictive value of the variables for one-year mortality was assessed by multiple logistic regression analysis.

The mean albumin was 31.0 g/L with 73% of patients less than 35 g/L and the mean TLC was 1.19×10(9) cells/L with 81% less than 1.50×10(9) cells/L. There were no significant differences in albumin (p=0.674) or TLC (p=0.804) between men and women. Survival information was obtained in 149 patients who received surgical treatment. The general one-year mortality was 31% with 35% in men and 29% in women, respectively. The surviving patients were younger and had higher albumin, TLC and calcium than those who died. However, multivariate analysis identified only serum albumin and TLC as independent and significant risk factors associated with one-year mortality; the optimal cut-off points were 29.5 g/L and 0.93×10(9) cells/L, respectively, based on the receiver operating characteristic (ROC) curve.

Malnutrition is a common phenomenon in an aged Chinese population suffering from intertrochanteric fractures. A lower serum albumin level and total lymphocyte count at admission are significant risk factors to predict the one-year mortality.