Altered seric levels of albumin, sodium and parathyroid hormone may predict early mortality following hip fracture surgery in elderly

Lizaur-Utrilla, Alejandro; Gonzalez-Navarro, Blanca; Vizcaya-Moreno, María Flores; Lopez‐Prats, Fernando A.

doi:10.1007/s00264-019-04368-0

Cited by 21 publications

(25 citation statements)

References 29 publications

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“…The intensity of this stress metabolism depends of the extension of trauma, that initiates an acute inflammation in minutes to hours, thus resulting in post-traumatic protein catabolism that can persist for around four months. ( 14 A sufficient quantity of proteins is essential for wound healing and immune response; ( 4 ), ( 15 however, the nutritional status of surgical patients is still disregarded, even for oncologic patients. ( 16 …”

Section: Discussionmentioning

confidence: 99%

“…The nutritional status of surgical patients is an important factor in postoperative complications, including surgical site infection and mortality rates. ( 4 Malnutrition is associated with prolonged hospital stay and complications due to surgical stress. ( 17 However, studies on the influence of hypoalbuminemia on outcomes and complications of microsurgical flaps for traumatic limb injuries is scarce, being only available for microsurgical flaps for oncologic reconstructions.…”

Section: Discussionmentioning

confidence: 99%

“…2 The posttraumatic hypoalbuminemia is questioned not to be an indication of malnutrition but as a biomarker for inflammatory status, 3 although it is commonly associated with complications and malnutrition in studies for orthopedic surgeries. 4 Microvascular flap reconstruction technique has evolved, reaching excellent outcomes with a reduced incidence of complications. 5 However, the treatment of these injuries in traumatic limb reconstruction still presents higher incidences of complications when compared with the treatment for head, neck, and breast.…”

Section: Introductionmentioning

confidence: 99%

“…( 2 The posttraumatic hypoalbuminemia is questioned not to be an indication of malnutrition but as a biomarker for inflammatory status, ( 3 although it is commonly associated with complications and malnutrition in studies for orthopedic surgeries. ( 4 …”

Section: Introductionmentioning

confidence: 99%

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Hypoalbuminemia in Microsurgical Flaps of the Musculoskeletal Apparatus

Silva

Cho

et al. 2020

Acta ortop. bras.

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Objective: To evaluate if the levels of serum total protein and serum albumin are risk factors for surgical complications of free flap limb reconstruction. Methods: Consecutive inclusion of all patients undergoing microsurgical flaps for limb reconstruction of complex injuries. We recorded epidemiological and laboratory data, including total proteins and fractions, for descriptive and analytical statistics. Results: Our study analyzed one microsurgical flap from 35 patients that underwent complex injuries of the limbs. In total, 23 patients were men, and mean age of all patients was 35 years. After statistical analysis, no influence of pre or postoperative hypoalbuminemia was observed on the incidence of complications. Patients with hypoalbuminemia had a higher length of stay than those with normal albumin levels (p = 0.008). Conclusion: We observed that 71% of patients had hypoalbuminemia in early postoperative period and we suggest a nutritional support for patients requiring complex traumatic limb reconstruction. Hypoalbuminemia in patients subjected to microsurgical flaps for the treatment of complex traumatic limb injuries did not influence the complications that required surgical reintervention; However, it was associated with prolonged hospital stay. Level of Evidence II, Retrospective study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hypoalbuminemia in Microsurgical Flaps of the Musculoskeletal Apparatus

Silva

Cho

et al. 2020

Acta ortop. bras.

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“…10 Low levels of the plasma protein albumin, considered an important marker of the nutritional status, is associated with adverse outcomes. 1,11 -13 Other markers that have been associated with mortality by multiple studies in patients with proximal femoral fractures include low preoperative hemoglobin levels, 11,14,15 low total leukocyte count 11,16,17 , high creatinine, 11,14 high parathyroid hormone, 1,11,18 high troponins 19 and high potassium. 14…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Metabolic Profiling in Older Patients With a Proximal Femoral Fracture

Sijp

Suchiman

Eijk

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: High mortality rates of approximately 20% within 1 year after treatment are observed for patients with proximal femoral fractures. This preliminary study explores the prognostic value of a previously constructed mortality risk score based on a set of 14 metabolites for the survival and functional recovery in patients with proximal femoral fractures. Materials and Methods: A prospective observational cohort study was conducted including patients admitted with a proximal femoral fracture. The primary outcome was patient survival, and the recovery of independence in activities of daily living was included as a secondary outcome. The mortality risk score was constructed for each patient and its prognostic value was tested for the whole population. Results: Data was available form 136 patients. The mean age of all patients was 82.1 years, with a median follow-up of 6 months. Within this period, 19.0% of all patients died and 51.1% recovered to their prefracture level of independence. The mortality score was significantly associated with mortality (HR, 2.74; 95% CI, 1.61-4.66; P < 0.001), but showed only a fair prediction accuracy (AUC = 0.68) and a borderline significant comparison of the mortality score tertile groups in survival analyses (P = 0.049). No decisive associations were found in any of the analyses for the functional recovery of patients. Discussion: These findings support the previously determined prognostic value of the mortality risk score. However, the independent prognostic value when adjusted for potential confounding factors is yet to be assessed. Also, a risk score constructed for this specific patient population might achieve higher accuracies for the prediction of survival and functional recovery. Conclusions: A modest prediction accuracy was observed for the mortality risk score in this population. More elaborate studies are needed to validate these findings and develop a tailored model for clinical purposes in this patient population.

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