Preoperative albumin as a predictor of one-year mortality in patients with fractured neck of femur

Wkm Kieffer,Aj Gandhe,Cs Rennie

doi:10.1308/003588413x13511609954815

Wkm Kieffer, Aj Gandhe + Show 1 more

Open Access

https://doi.org/10.1308/003588413x13511609954815

Copy DOI

Abstract

A simple measure to determine one-year mortality following hip fractures has its benefits. Where there is controversy over implant selection, such a scoring system can facilitate the decision-making process. We undertook a retrospective analysis of one-year postoperative mortality of our hip fracture patients and established their admission serum albumin levels to see if there was any correlation between this and one-year mortality. Our results showed one-year mortality was significantly higher (p=0.0049) for those patients with a serum albumin of <35g/dl. Of the patients with low albumin, we found that there was no statistical significance between one-year mortality and source of admission (p=0.0789). Prefracture serum albumin can be used as a simple predictor of one-year mortality in patients presenting with a fractured neck of femur, thereby aiding operative planning and implant selection with a view to likely survival and possible need for revision.

Highlights

A simple measure to determine one-year mortality following hip fractures has its benefits
The mortality for fractured neck of femur can be measured using previously published scoring systems[4] but these can be cumbersome and sometimes impractical when deciding on patient management
While trauma surgeons will have developed their own informal criteria for deciding who is managed with each option, a biochemical predictor of mortality that is quick and easy to interpret would be useful in aiding that decision so that those patients who are likely to live longer do not suffer from the complications associated with the aforementioned implants or have an implant that is easier to revise or modify should the need arise

Summary

Introduction

A simple measure to determine one-year mortality following hip fractures has its benefits. Prefracture serum albumin can be used as a simple predictor of one-year mortality in patients presenting with a fractured neck of femur, thereby aiding operative planning and implant selection with a view to likely survival and possible need for revision. The mortality for fractured neck of femur can be measured using previously published scoring systems (eg Nottingham Hip Fracture Score [NHFS])[4] but these can be cumbersome and sometimes impractical when deciding on patient management. Predictors of increased one-year mortality already known from the literature and components of the NHFS include increased age, male sex, low mini-mental state examination score, low haemoglobin levels, presence of malignancy, prefracture institutional residence and increased number of co-morbidities.[4] While the majority of these factors are calculable on admission, there are some factors that cannot be recorded adequately in the acute setting, thereby limiting their usefulness in operative planning

Objectives

Methods

Results

Discussion

Conclusion