Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture

Abstract

Aim: To evaluate the prognostic impact at admission of 10 biochemical indices for prediction postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In 1273 consecutive patients with HF (mean age 82.9 ± 8.7 years, 73.5% women), clinical and laboratory parameters were collected prospectively, and outcomes were recorded. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were preformed, the number needed to predict (NNP) outcome was calculated. Results: Age ≥ 80 years and IHD were the most prominent clinical factors associated with both PMI (with cardiac troponin I rise) and in-hospital death. PMI occurred in 555 (43.6%) patients and contributed to 80.3% (49/61) of all deaths (mortality rate 8.8% vs.1.9% in non-PMI patients). The most accurate biochemical predictive markers were parathyroid hormone > 6.8 pmol/l, urea > 7.5 mmol/l, 25(OH)vitamin D < 25 nmol/l, albumin < 33 g/l, and ratios gamma-glutamyl transferase (GGT) to alanine aminotransferase > 2.5, urea/albumin ≥ 2.0 and GGT/albumin ≥ 7.0; the AUC for developing PMI ranged between 0.782 and 0.742 (NNP: 1.84–2.13), the AUC for fatal outcome ranged from 0.803 to 0.722, (NNP: 3.77–9.52). Conclusions: In HF patients, easily accessible biochemical indices at admission substantially improve prediction of hospital outcomes, especially in the aged > 80 years with IHD.

Prognostic value of the systemic immune-inflammation index in critically ill elderly patients with hip fracture: evidence from MIMIC (2008–2019)

“…Another research investigation demonstrated that those with a significantly higher plasma anion gap have a poorer clinical outcome and an increased likelihood of dying while in the hospital ( 28 ). Biochemical ionic disturbances, blood urea nitrogen, and total bilirubin levels on admission have also been associated with a poorer prognosis for hip fracture ( 29 ). The SOFA score, a metric for evaluating disease severity in ICU patients, has been linked to an unfavorable outcome in fracture patients ( 30 ).…”

Platelet-to-Lymphocyte Ratio (PLR) and Lymphocyte-to-Monocyte Ratio (LMR) at Admission Predict Survival in Hip Fracture Patients

“…In a prospectively collected cohort of 1,256 consecutive patients (older than 65 years) admitted to the Department of Orthopaedics Surgery of our hospital with a HF (mean age 82.9 ± 8.7[SD] years, 50.5 % with cervical fracture, 73.5% females) we analyzed admission levels of PLR and LMR as well as the sociodemographic, clinical and numerous routine laboratory parameters in regard to in-hospital all-cause mortality. Detailed descriptions of this cohort, inclusion and exclusion criteria, have been published in another article [5]. Multivariate stepwise logistic regression analyses were performed with cut-offs for PLR >280 (the fourth quartile) and for LMR <1.1 (the first quartile).…”

The Possible Influence of Vitamin D Levels on the Development of Atrial Fibrillation—An Update

“…It is also necessary to discuss the limitations associated with the study group. There are papers that appear in which the limitation is still the small size of the study group as well as the very large size of the study group which is difficult to systematize [ 96 , 113 , 140 ]. Therefore, it is currently more difficult and important to complete a representative group that will apply to a random patient [ 25 , 107 , 110 ].…”