The effect of blood parameters measured in the emergency department on 30-day mortality in patients with proximal femur fractures: A retrospective analysis

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Proximal femur fractures (PFF) are a common and significant health problem in the elderly population, often leading to morbidity and mortality. This study aims to investigate the association between hematological and biochemical parameters measured at admission and 30-day mortality by retrospectively evaluating patients diagnosed with PFF in the emergency department. This retrospective study includes 344 patients over the age of 65 who admitted to the Emergency Medicine Department of Afyonkarahisar Health Science University Faculty of Medicine Hospital and were diagnosed with PFF between January 1st, 2018, and July 1st, 2023. The patients' demographic characteristics, PFF-related features, and their hematological and biochemical parameters at presentation, were recorded. Specific parameters were proportionally analyzed in accordance with relevant literature. The relationship between these findings and 30-day mortality was evaluated. Of the included patients, 59.6% were female, with a mean age of 81.88 ± 7.76 years. The 30-day mortality rate was 7%. A significant difference was observed in the mortality group regarding ICU admission history, length of hospital stays, glucose/potassium ratio, WBC, neutrophil, hemoglobin, and RDW levels. According to ROC analysis, the AUC for hemoglobin was 0.641 (95% CI: 0.589–0.690), with a cutoff value of <12.8, yielding a sensitivity of 87.5% and specificity of 36.0% (p=0.01). For RDW, the AUC was 0.721 (95% CI: 0.672–0.767), with a cutoff value of >16.2, resulting in a sensitivity of 54.2% and specificity of 86.7% (p=0.001). Hemoglobin, red cell distribution width, and glucose/potassium ratio levels in the emergency department are associated with 30-day mortality in patients diagnosed with PFF. Evaluating these parameters in clinical practice may aid in the early identification of high-risk patients and facilitate the planning of appropriate treatment strategies. Future research should validate these findings through larger-scale studies.