Prognostic Significance Of Serum Urea Concentration at Admission in older patients with hip fracture

Alexander Fisher,Leon Fisher,Wichat Srikusalanukul,Paul N Smith

doi:10.2174/1874325001812010486

Abstract

Background: There are unmet needs in objective prognostic indicators for Hip Fracture (HF) outcomes.

Highlights

In the last two decades, serum urea concentration, the terminal product of protein metabolism, received much1874-3250/18 2018 Bentham OpenSerum Urea at Admission and Hip Fracture OutcomesThe Open Orthopaedics Journal, 2018, Volume 12 487 attention as a simple and reliable biochemical parameter for predicting adverse outcomes, especially short- and longterm mortality, in various medical and surgical settings including cardiovascular, cerebrovascular, respiratory, liver, pancreatic, septic and critically ill patients [1 - 11]
Patients with increased admission urea and a high inflammatory response had 9.7 times greater mortality odds compared to patients without such characteristics
In each patient, fasting venous blood samples were collected on admission and the following assays performed: urea and electrolytes, complete blood count, C-Reactive Protein (CRP), liver (Alanine aminotransferase [alanine aminotransferase (ALT)], GammaGlutamyl Transferase [gamma-glutamyl transferase (GGT)], alkaline phosphatase [ALP], bilirubin and albumin) and thyroid function tests, 25 (OH) vitamin D [(25(OH)D], intact parathyroid hormone (PTH) and indices of iron metabolism using standard methods and commercially available kits as we described previously [20]

Summary

Introduction

In the last two decades, serum urea concentration, the terminal product of protein metabolism, received much1874-3250/18 2018 Bentham OpenSerum Urea at Admission and Hip Fracture OutcomesThe Open Orthopaedics Journal, 2018, Volume 12 487 attention as a simple and reliable biochemical parameter for predicting adverse outcomes, especially short- and longterm mortality, in various medical and surgical settings including cardiovascular, cerebrovascular, respiratory, liver, pancreatic, septic and critically ill patients [1 - 11]. Serum Urea at Admission and Hip Fracture Outcomes. Liver is the main ureagenic organ and routine hepatocyte function parameters (albumin levels, enzyme activities) have been found to be valuable prognostic indicators for poor outcomes in HF patients [19 - 22], no study was performed on the relationship between serum urea, liver function characteristics at admission and outcomes in HF. The aims of this study were to assess in a representative sample of older HF patients [1] the prevalence and determinants of elevated serum urea level at admission, [2] its association with short-term outcomes, and [3] the potential prognostic impact alone and in combination with clinical and other biochemical characteristics, focussing on liver-specific and protein metabolism-related variables. There are unmet needs in objective prognostic indicators for Hip Fracture (HF) outcomes.

Objectives

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Discussion

Conclusion