Correlation between C-reactive protein/albumin and contralateral hip refracture after total hip arthroplasty in elderly patients with hip fractures

Chen, Lu; Zhang, Jian-guang; Zhang, Wei; Deng, Changgong

doi:10.21037/apm-20-855

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…The CAR, a combination of two circulating acute phase proteins, is an inflammation-based prognostic factor that can be used as a prognostic factor in postoperative patients (33). According to a recent report, the CAR can help predict the risk of postoperative death in elderly patients with hip fracture (34), and the combination of CRP and Alb with POD was more likely to reflect preexisting inflammatory stress than CRP or Alb alone. There is compelling evidence that the release of proinflammatory cytokines into the peripheral and central nervous system plays a crucial role in the pathogenesis of POD (7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

The C-reactive protein/albumin ratio predicts postoperative delirium in patients older than 60 years following total knee arthroplasty

Zhang

Li²,

Bai³

et al. 2022

Front. Surg.

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PurposeThis study aimed to investigate the relationship between serum C-reactive protein (CRP)/Albumin ratio (CAR) and postoperative delirium (POD) in patients older than 60 years following total knee arthroplasty (TKA).MethodsFrom January 2019 to January 2021, 268 patients were recruited in this prospective observational investigation. Patients with serum CRP, Alb, CAR, delirious status and delirious score were assessed. The effect of CRP, Alb, CAR on predicting delirium was assessed with the area under the receiver operating characteristic (ROC) curve (AUC).ResultsThe study found that higher CRP level (P < 0.001), low Alb level (P < 0.001), and higher CAR (P < 0.001) were independently associated with POD. The AUC of CAR for POD was 0.782, with the cut-off value of 0.117, a sensitivity of 83.3% and a specificity of 65.9% respectively (P < 0.001), suggesting that CAR had moderate efficacy on predicting POD occurrence than CRP (AUC: 0.761) and Alb (AUC: 0.300). The results also showed that age, ASA and the operation time was an independent predictor for patients with POD.ConclusionsOur findings demonstrated CAR may be an effective biomarker to predict postoperative delirium in patients over 60 years of age with TKA, which provides potential recommendations for early intervention in delirium care.

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Section: Discussionmentioning

confidence: 99%

The C-reactive protein/albumin ratio predicts postoperative delirium in patients older than 60 years following total knee arthroplasty

Zhang

Li²,

Bai³

et al. 2022

Front. Surg.

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“…Preoperative CRP was found to be a primary risk factor for postoperative death in elderly patients with hip fractures in a recent study ( 39 ). Chen et al ( 37 ) reported that the serum CRP/Alb ratio is a risk factor in elderly hip fracture patients treated by total hip arthroplasty. In our study, there was no difference between the patient’s preoperative and postoperative laboratory tests of hematocrit, D-dimer level, and CRP level between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for contralateral hip refractures in patients aged over 80 years with intertrochanteric femoral fractures

Zhong

et al. 2022

Front. Surg.

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PurposeThe purpose of this study was to identify which of the risk factors would contribute to the contralateral fracture in very elderly patients after intramedullary nail fixation.MethodsClinical data of 227 intertrochanteric fracture patients aged 80 years or older were retrospectively reviewed. Intramedullary nails (IMNs) were used on all of the patients. Potential risk factors for contralateral hip refractures were determined using univariate and logistic regression analyses.ResultsContralateral hip refractures occurred in 11 patients (4.84%). Univariate analysis revealed that age, gender, body mass index, fracture classification, hematocrit, D-dimer, and CRP level were not associated with contralateral fractures (P > 0.05). However, neurological diseases, cardiovascular disease, and visual impairments were significantly associated with contralateral fractures (P < 0.05). Multivariate analysis further revealed that neurological diseases (OR 4.25, P = 0.044) and visual impairments (OR 5.42, P = 0.015) were independent risk factors associated with contralateral refractures.ConclusionTo prevent contralateral refractures, more attention should be paid to elderly intertrochanteric fracture patients with underlying neurological disease and visual impairments.

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“…For instance, the AGR was markedly decreased in the infectious RHD patients, and the AGR, CAR, mGPS, and PLR were determined as specific indices for the differentiation between infectious and non-infectious RHD (Table 7 ). The importance of nutritional assessment has been demonstrated in oncology 15 and is increasingly reported in orthopedics patients 16 – 19 . However, this study may be the first to report the utility of these combination indexes in RHD infection diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…We calculated the AGR, CAR, GPS, mGPS, PNI, GNRI, NLR, PLR, and LMR. These metrics indicate systemic nutritional status, systemic inflammation, and immune status (Supplementary Table S2 ) 16 , 17 , 22 , 33 – 42 . All data were calculated from blood samples obtained during the first visit to our hospital after the appearance of clinical onset with femoral destruction.…”

Section: Methodsmentioning

confidence: 99%

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

Abe

Choe

Oba

et al. 2022

Sci Rep

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Preoperative diagnosis of infection is important for appropriate surgical treatment of patients with rapid hip destruction (RHD). We investigated whether test results, including inflammatory and nutritional markers, could be used to accurately differentiate infectious and non-infectious RHD. Fifty patients with RHD who underwent total hip arthroplasty within a year of onset were observed. Infectious RHD was defined as ≥ 2 positive serological inflammatory, microbiological, or pathological evaluations. The albumin to globulin ratio (AGR), C-reactive protein (CRP)/albumin ratio (CAR), Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and platelet to lymphocyte ratio (PLR) were calculated from the blood test results. In the infectious group, the white blood cell count, platelet count, CRP level, erythrocyte sedimentation rate, CAR, GPS, mGPS, and PLR were significantly higher, while the albumin level, AGR, PNI, and GNRI were significantly lower. The CRP and albumin levels showed the highest sensitivity (1.00 for both; specificity of 0.87 and 0.73, respectively) in diagnosing infectious RHD. Combining these measurements (CAR) increased the specificity to 0.92. The accuracy of other nutritional assessments was good. Thus, nutritional assessment as well as conventional assessment of the inflammatory response can improve the accuracy of preoperative diagnosis of infectious RHD.

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Correlation between C-reactive protein/albumin and contralateral hip refracture after total hip arthroplasty in elderly patients with hip fractures

Cited by 10 publications

References 11 publications

The C-reactive protein/albumin ratio predicts postoperative delirium in patients older than 60 years following total knee arthroplasty

The C-reactive protein/albumin ratio predicts postoperative delirium in patients older than 60 years following total knee arthroplasty

Risk factors for contralateral hip refractures in patients aged over 80 years with intertrochanteric femoral fractures

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

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