C-Reactive Protein to Albumin Ratio May Predict Mortality for Elderly Population Who Undergo Hemiarthroplasty Due to Hip Fracture

Abstract

Background Although the relationship of preoperative C-reactive protein (CRP) and albumin levels to mortality in elderly patients who have undergone surgery due to hip fracture has been previously investigated, the CRP to albumin ratio (CAR) has not been investigated. This study aimed to investigate the relationship between preoperative CAR and mortality. Methods A total of 254 patients (mean age, 78.74 years) were retrospectively analyzed using the following data: age, gender, fracture type, American Society of Anesthesiologists (ASA) score, type of anesthesia, time between fracture and surgery, time between fracture and discharge, length of hospital stay, preexisting comorbidities, preoperative CRP and albumin levels, and mortality. The serum CRP level was divided by the serum albumin level to calculate the preoperative CAR. Multivariate logistic regression was used to evaluate the association between risk factors and 1-year mortality. Results One-year mortality was 22.8% (58 patients). Age >85 years, male gender, ASA score ≥3, presence of ≥3 comorbidities, and CAR ≥2.49 were identified as mortality risk factors in the univariate analysis. The following factors were included in the binary logistic regression analysis to determine the major predictors of 1-year mortality: ASA score ≥3, presence of ≥3 comorbidities, and CAR ≥2.49. Conclusion Detection of CAR above 2.49 is a strong indicator for 1-year mortality in patients operated due to hip fracture in the elderly population. ASA score ≥3 and presence of ≥3 comorbid diseases were also related to mortality.