Association between admission albumin levels and 30-day readmission after hip fracture surgery in geriatric patients: a propensity score-matched study

Abstract

Purpose This study aimed to evaluate the correlation admission albumin levels and 30-day readmission after hip fracture surgery in geriatric patients. Methods In this retrospective cohort study, 1270 geriatric patients admitted for hip fractures to a level I trauma center were included. Patients were stratified by clinical thresholds and albumin level quartiles. The association between admission albumin levels and 30-day readmission risk was assessed using multivariate logistic regression and propensity score-matched analyses. The predictive accuracy of albumin levels for readmission was evaluated by ROC curves. The dose–response relationship between albumin levels and readmission risk was examined. Results The incidence of 30-day readmission was significantly higher among hypoalbuminemia patients than those with normal albumin levels (OR = 2.090, 95%CI:1.296–3.370, p = 0.003). Furthermore, propensity score-matched analyses demonstrated that patients in the Q2(35.0–37.9 g/L) (OR 0.621, 95%CI 0.370–1.041, p = 0.070), Q3(38.0–40.9 g/L) (OR 0.378, 95%CI 0.199–0.717, p < 0.001) and Q4 (≥ 41 g/L) (OR 0.465, 95%CI 0.211–0.859, p = 0.047) quartiles had a significantly lower risk of 30-day readmission compared to those in the Q1(< 35 g/L) quartile. These associations remained significant after propensity score matching (PSM) and subgroup analyses. Dose–response relationships between albumin levels and 30-day readmission were observed. Conclusions Lower admission albumin levels were independently associated with higher 30-day readmission rates in elderly hip fracture patients. Our findings indicate that serum albumin may assist perioperative risk assessment, and prompt correction of hypoalbuminemia and malnutrition could reduce short-term readmissions after hip fracture surgery in this high-risk population.