Biomarkers as predictors of inpatient mortality in fractured neck of femur patients

Geleit, Ryan; Bence, Matthew; Samouel, Phillip; Craik, Johnathan D.

doi:10.1016/j.archger.2023.105004

Cited by 2 publications

(3 citation statements)

References 38 publications

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“…The SIRI is calculated from peripheral neutrophil, monocyte and lymphocyte ( 20 ). As described above, these blood indicators were significant predictors of death after hip fracture ( 10 , 13 – 15 ). Furthermore, we also found that high monocyte level was associated with an increased risk of deep venous thrombosis (DVT) in older patients with hip fracture, thereby leading to a 3.21-fold increase in the 30-day mortality ( 29 , 30 ).…”

Section: Introductionmentioning

confidence: 58%

“…Recently, two network meta-analyses, each including over 100 randomized controlled trails, reported that the 1-year mortality rates of femoral neck and intertrochanteric fracture after surgery were as high as 23.5 and 20.2%, respectively ( 6 , 7 ). Therefore, to improve the prognosis of these patients, it is of great clinical significance to identify predictors for recognizing patients at high risk of death and for optimizing treatment strategies ( 8 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…Attributing to easy availability and low cost in clinical practice, several blood indicators have been found to be associated with increased mortality in patients with hip fracture, including C-reactive protein (CRP) ( 11 ), albumin ( 10 , 12 ), lymphocyte ( 10 ), neutrophil and monocyte ( 13 ). Based on these laboratory indicators, some integrated markers of systemic inflammation and immunity were further applied to the assessment of hip fracture prognosis, such as neutrophil-to-lymphocyte ratio (NLR) ( 14 ), monocyte-to-lymphocyte ratio (MLR) ( 15 ), neutrophil-to-albumin ratio (NAR) ( 16 ), and CRP-to-albumin ratio (CAR) ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Fang,

Gao,

Wang

et al. 2024

Front. Med.

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ObjectiveWith a rapidly aging global population, the assessment of mortality risk following hip fracture in older adults has received increasing attention. Recently, the system inflammation response index (SIRI) has been identified as a novel prognostic marker to reflect both systemic inflammation and immune status. However, it is not yet known whether SIRI is a potential predictor of subsequent death in hip fracture patients. Therefore, this study aimed to investigate the association between SIRI and mortality in older patients with hip fracture.MethodsA total of 1,206 older hip fracture patients undergoing surgery between January 2013 and December 2022 were consecutively derived from our longitudinal database. Patients were divided into three groups according to SIRI tertiles, calculated as neutrophil × monocyte / lymphocyte. Survival status was obtained from medical records or telephone interviews, and the study outcome was all-cause mortality after hip fracture at the longest follow-up. Multivariate Cox proportional hazard model and restricted cubic spline (RCS) regression model were used to evaluate the association between SIRI and mortality. Moreover, a series of sensitivity analyses were conducted to further validate the robustness of the association.ResultsDuring a median follow-up of 43.85 months, 337 patients (27.94%) died. After full adjustment, each unit increase in SIRI was significantly associated with a 2.2% increase in overall mortality (95% confidence interval [CI]: 1.001–1.042, p = 0.029). Similarly, compared with the first tertile of SIRI, the second and third tertile showed a 1.335-fold (95% CI: 1.011–1.762, p = 0.042) and 1.447-fold (95% CI, 1.093–1.917, p = 0.010) higher risk of death. Sensitivity analyses confirmed the stability of the association. Moreover, RCS analysis revealed a positive non-linear relationship between SIRI and mortality (P for nonlinearity = 0.021).ConclusionHigh SIRI level at admission was significantly and positively associated with an increased risk of death, suggesting that SIRI may be an independent predictor of mortality in older patients with hip fracture.

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Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Fang,

Gao,

Wang

et al. 2024

Front. Med.

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Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues

Fisher,

Srikusalanukul

2024

JCM

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Objectives: This study, based on the concept of immuno-inflammatory–metabolic (IIM) dysregulation, investigated and compared the prognostic impact of 27 indices at admission for prediction of postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In consecutive HF patient (n = 1273, mean age 82.9 ± 8.7 years, 73.5% females) demographics, medical history, laboratory parameters, and outcomes were recorded prospectively. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were used to establish the predictive role for each biomarker. Results: Among 27 IIM biomarkers, 10 indices were significantly associated with development of PMI and 16 were indicative of a fatal outcome; in the subset of patients aged >80 years with ischaemic heart disease (IHD, the highest risk group: 90.2% of all deaths), the corresponding figures were 26 and 20. In the latter group, the five strongest preoperative predictors for PMI were anaemia (AUC 0.7879), monocyte/eosinophil ratio > 13.0 (AUC 0.7814), neutrophil/lymphocyte ratio > 7.5 (AUC 0.7784), eosinophil count < 1.1 × 109/L (AUC 0.7780), and neutrophil/albumin × 10 > 2.4 (AUC 0.7732); additionally, sensitivity was 83.1–75.4% and specificity was 82.1–75.0%. The highest predictors of in-hospital death were platelet/lymphocyte ratio > 280.0 (AUC 0.8390), lymphocyte/monocyte ratio < 1.1 (AUC 0.8375), albumin < 33 g/L (AUC 0.7889), red cell distribution width > 14.5% (AUC 0.7739), and anaemia (AUC 0.7604), sensitivity 88.2% and above, and specificity 85.1–79.3%. Internal validation confirmed the predictive value of the models. Conclusions: Comparison of 27 IIM indices in HF patients identified several simple, widely available, and inexpensive parameters highly predictive for PMI and/or in-hospital death. The applicability of IIM biomarkers to diagnose and predict risks for chronic diseases, including OP/OF, in the preclinical stages is discussed.

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Biomarkers as predictors of inpatient mortality in fractured neck of femur patients

Cited by 2 publications

References 38 publications

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues

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