Association between inflammation-based prognostic markers and mortality after hip replacement.

Area of Science:

• Orthopedic Surgery
• Inflammatory Markers
• Prognostic Indicators

Background:

• Hip replacement surgery is a common procedure with potential postoperative complications.
• Inflammation-based prognostic markers are increasingly recognized for their role in predicting patient outcomes.

Purpose of the Study:

• To evaluate the association between inflammation-based prognostic markers and mortality after hip replacement.
• To determine the predictive value of CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for postoperative mortality.

Main Methods:

• A cohort of 5,369 adult patients undergoing hip replacement between March 2010 and June 2020 was analyzed.
• Preoperative C-reactive protein (CRP), albumin, and complete blood count were used to calculate CAR, NLR, and PLR.
• Receiver operating characteristic (ROC) curves were used to establish optimal thresholds for these markers, and mortality risk was compared based on these thresholds.

Main Results:

• One-year mortality was 2.9%.
• High CAR (threshold 2.10) and NLR (threshold 3.16) were significantly associated with increased one-year mortality (HR=2.16, p=0.002 for CAR; HR=2.05, p=0.01 for NLR) after adjustment.
• Platelet-to-lymphocyte ratio (PLR) did not show a significant association with mortality (HR=1.12, p=0.57).

Conclusions:

• Preoperative CAR and NLR are valuable indicators for predicting one-year mortality in patients undergoing hip replacement.
• These inflammation-based markers can assist clinicians in identifying high-risk patients and potentially guiding perioperative management.