Predictive Value of Blood Parameters and Comorbidities on Three-Month Mortality in Elderly Patients With Hip Fracture

Demirel, Esra; Şahin, Ali Feyzullah

doi:10.7759/cureus.18634

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…In human patients, systemic lactate concentration is a prognostic indicator and can be used to predict death after a hip or pertrochanteric fracture. [26][27][28][29][30] The present study had not found a similar association between hyperlactatemia and death after a long-bone fracture in cattle. This difference is probably because the lactate concentration was mainly used to assess ischemia and hypoxia at the whole-body level of human patients more severely compromised than the cattle patients included in our study.…”

Section: Discussionmentioning

confidence: 58%

“…[23][24][25] Lactate concentration can be used as a prognostic indicator and predict death in human patients diagnosed with hip or pertrochanteric fractures. [26][27][28][29][30] Additionally, long-bone and pelvic fracture repair in human patients with increased lactate concentration has been associated with greater postoperative morbidity. 31,32 The determination of whether lactate concentrations are of prognostic value in cattle diagnosed with a long-bone fracture has not been studied previously.…”

Section: Clinical Relevancementioning

confidence: 99%

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Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

Constant

Marchionatti

Desrochers

et al. 2023

javma

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OBJECTIVE To determine the prognostic value of lactate concentration measurements at admission in cattle with long-bone fractures. ANIMALS 43 cattle with long-bone fractures between July 2016 and Dec 2018. PROCEDURES In this prospective cohort study, lactate concentration was measured in systemic venous blood and locally in capillary blood sampled from the fractured and contralateral limbs of cattle and assessed for outcome prediction. The cutoff value was determined by maximizing the Youden index from receiver-operating characteristic curves. Multivariable logistic regression was employed to verify whether higher lactate concentrations compared with the cutoff value were an independent risk factor for poor outcomes at 30 days or 3 years after admission. RESULTS Poor outcome was associated with higher capillary lactate concentration in the fractured limb (P < .001) and greater difference with systemic blood (P = .005). A cutoff value of lactate difference ≥ 2.4 mmol/L (sensitivity = 0.80; specificity = 0.965) between capillary lactate in the fractured limb and systemic blood was the best predictor of death ≤ 30 days after admission (P < .001). Multivariable analysis revealed that this cutoff value was an independent risk factor for 30-day and 3-year outcomes (P < .001). CLINICAL RELEVANCE Admission blood lactate concentration difference ≥ 2.4 mmol/L between the fractured limb and systemic blood was a robust and independent predictor of outcome for cattle of the present report. Lactate metabolism is locally impaired in fractured limbs of nonsurviving or at higher complication risk cattle, which may help identify patients at high risk for poor outcomes.

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Section: Discussionmentioning

confidence: 58%

Section: Clinical Relevancementioning

confidence: 99%

Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

Constant

Marchionatti

Desrochers

et al. 2023

javma

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“…(37) According to the literature, a high level of creatinine is one of the markers of the risk of early mortality in elderly patients with fractures of the proximal femur. (38) There were no differences in creatinine levels in SHR rats compared to healthy Wistar rats.…”

Section: Groups Groupsmentioning

confidence: 85%

The Enalapril Use in Arterial Hypertension Stimulates The Reparative Processes in Fractures of The Proximal Femur

et al. 2022

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BACKGROUND: In patients with a fracture of the proximal femur and concomitant arterial hypertension, there is a disturbance of the reparative processes of bone tissue. This research aimed to study the regulation of the reparative processes of fractures of the proximal femur with intramedullary osteosynthesis during the correction of concomitant hypertension, which was examined based on some markers using the rat model.METHODS: The study involved healthy Wistar rats and spontaneously hypertensive rats (SHR). The subjects were then grouped into healthy rats without exposure (1.1) SHR without exposure (2.1), healthy rats with modeled fractures of the proximal femur (1.2), SHR with modeled fractures of the proximal femur (2.2), SHR underwent hypertension correction with enalapril in subgroups without fracture (2.3) and SHR underwent hypertension correction with enalapril in subgroups with fracture (2.4). The levels of interleukin (IL)-6, tumor necrosis factor alpha (TNF-a), IL-10, amino-terminal propeptide procollagen type III (PIIINP), glucose, uric acid, creatinine, urea, cholesterol, and albumin were determined in the blood serum of the animals. Femur preparations were examined after the removal of intramedullary fixation. RESULTS: Serum IL-6 level of animal in group 2.4 (2.297±0.361 pg/mL) were reduced compared to the corresponding indicators of rats in group 2.3 (4.054±0.491 pg/mL, p<0.05). Serum glucose and urea levels of animal in group 2.4 (3.951±0.156 mmol/L, 6.552±0.426 mmol/L, respectively) were significantly reduced in comparison with the group 2.3 (6.384±0.890 mmol/L, 10.369±0.888 mmol/L, respectively). The histological results indicated a positive effect of the drug enalapril on the healing of fractures of the proximal femur in animals with hypertension.CONCLUSION: Correction of arterial hypertension with enalapril in fractures of the proximal femur improves the reparative processes of bone tissue.KEYWORDS: injury healing, remodeling, concomitant diseases, angiotensin-converting enzyme inhibitors, cytokines, growth factor, collagen, biochemical parameters

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“…Associations have been found between the surgical approach 6 , Charlson Comorbidity Index 7 , delay from admission to surgery 8 , body mass index 9 , anticoagulant consumption 10 – 12 , type of anesthesia 13 and mortality or complications following hip fractures surgery have been previously discussed. Pre-operative factors like anemia 14 , nutritional parameters 15 , analytical values 16 , blood parameters 17 , and neutrophile to lymphocyte ratio can be measured by a blood test and the prognostic role of these variables is valuable.…”

Section: Introductionmentioning

confidence: 99%

Influencing factors on morbidity and mortality in intertrochanteric fractures

Babagoli¹,

Raeini²,

Sheykhvatan³

et al. 2023

Sci Rep

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We aimed to evaluate the effect of the patient’s clinical and paraclinical condition before and after surgery on short-term mortality and complication and long-term mortality. A retrospective cohort study was conducted and multivariate logistic regression was applied to determine the effect of demographic characteristics (sex, age, AO/OTA classification, height, weight, body mass index), medical history (hypertension, ischemic heart disease, diabetes mellitus, thyroid malfunction, cancer, osteoporosis, smoking) lab data (Complete blood cell, blood sugar, Blood Urea Nitrogen, Creatinine, Na, and K), surgery-related factors (Anesthesia time and type, implant, intraoperative blood transfusion, postoperative blood transfusion, and operation time), duration of admission to surgery and anticoagulant consumption on short-term mortality and complication and long-term mortality. Three hundred ten patients from November 2016 to September 2020 were diagnosed with an intertrochanteric fracture. 3.23% of patients died in hospital, 14.1% of patients confronted in-hospital complications, and 38.3% died after discharge till the study endpoint. ΔNumber of Neutrophiles is the primary determinant for in-hospital mortality in multivariate analysis. Age and blood transfusion are the main determinants of long-term mortality, and Na before surgery is the primary variable associated with postoperative complications. Among different analytical factors Na before surgery as a biomarker presenting dehydration was the main prognostic factor for in hospital complications. In hospital mortality was mainly because of infection and long-term mortality was associated with blood transfusion.

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Predictive Value of Blood Parameters and Comorbidities on Three-Month Mortality in Elderly Patients With Hip Fracture

Cited by 7 publications

References 31 publications

Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

The Enalapril Use in Arterial Hypertension Stimulates The Reparative Processes in Fractures of The Proximal Femur

Influencing factors on morbidity and mortality in intertrochanteric fractures

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