Elevated albumin: a protective factor against mortality in geriatric hip fracture patients

To evaluate the association between albumin concentration at admission and mortality in elderly patients with hip fractures.

Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between albumin concentration at admission and mortality. All analyses were performed using EmpowerStats and the R software.

This retrospective cohort study included 2387 patients who met the study criteria. The mean follow-up was 37.64 months. The albumin concentration was 37.72 ± 4.03 g/L. Multivariate Cox regression showed that albumin concentration was associated with mortality in geriatric patients with hip fracture (Hazard Ratio [HR] = 0.94, 95% confidence intervals [CI]:0.92-0.96, P < 0.0001). Compared to the low albumin group (< 35 g/L), the medium group (≥ 35 g/L and < 40 g/L) decreased mortality risk by 29% (HR = 0.71, 95%CI:0.59-0.86, P = 0.0003), and the high group (≥ 40 g/L) decreased mortality risk by 38% (HR = 0.62, 95%CI:0.49-0.79, P < 0.0001). In addition, the test for a linear trend (P for trend) also showed a linear correlation in the different models. No saturation or threshold effect was observed in the nonlinear association. The sensitivity analysis used propensity score matching, and the results were stable.

The albumin concentrations at admission were associated with mortality in geriatric hip fractures, and it could be considered a predictor for the risk of mortality. (ChiCTR2200057323).