The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study.

Abstract

To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures. Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between prealbumin concentration at admission and mortality. All analyses were performed using EmpowerStats and the R software. This cohort study included 2387 patients who met the study criteria. The mean follow-up was 37.64months. The prealbumin concentration was 162.67 ± 43.2mg/L. Multivariate Cox regression showed that prealbumin concentration was associated with mortality in geriatric patients with hip fracture (hazard ratio [HR] = 0.95, 95% confidence intervals [CI]: 0.93-0.97, P < 0.0001). In addition, an inflection point effect was observed in the nonlinear association. The inflection point was 162.2mg/L. If it is less than this inflection point, then every 10mg/L increase in prealbumin was associated with a 7% reduction in the risk of death (HR = 0.93, 95%CI: 0.90-0.96, P < 0.0001). Whengreater than the inflection point,there was nodifference in the risk of death (HR = 0.99, 95%CI: 0.95-1.03, P = 0.5127). The prealbumin concentrations at admission were nonlinearly associated with long-term mortality in geriatric hip fractures, and 162.2mg/L could be considered a prognostic factor of mortality risk.