Serum albumin and total lymphocyte count as predictors of outcome in hip fractures.

Hdl Handle:
http://hdl.handle.net/10147/207580
Title:
Serum albumin and total lymphocyte count as predictors of outcome in hip fractures.
Authors:
O'Daly, Brendan J; Walsh, James C; Quinlan, John F; Falk, Gavin A; Stapleton, Robert; Quinlan, William R; O'Rourke, S Kieran
Affiliation:
Department of Orthopaedic Surgery, St. Vincent's University Hospital, Elm Park,, Dublin 4, Ireland. brendan.odaly@ucd.ie
Citation:
Clin Nutr. 2010 Feb;29(1):89-93. Epub 2009 Aug 11.
Journal:
Clinical nutrition (Edinburgh, Scotland)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207580
DOI:
10.1016/j.clnu.2009.07.007
PubMed ID:
19674819
Abstract:
BACKGROUND & AIMS: Hip fractures are a significant cause of mortality and morbidity in the elderly. Malnutrition is a significant contributor to this, however no consensus exists as to the detection or management of this condition. We hypothesise that results of admission serum albumin and total lymphocyte count (TLC), as markers of Protein Energy Malnutrition (PEM) can help predict clinical outcome in hip fracture patients aged over 60 years. METHODS: This retrospective study evaluated the nutritional status of patients with hip fractures using albumin and TLC assays and analysed their prognostic relevance. Clinical outcome parameters studied were delay to operation, duration of in-patient stay, re-admission and in-patient, 3- and 12-month mortality. RESULTS: Four hundred and fifteen hip fracture patients were evaluated. Survival data were available for 377 patients at 12 months. In-hospital mortality for PEM patients was 9.8%, compared with 0% for patients without. Patients with PEM had a higher 12-month mortality compared to patients who had normal values of both laboratory parameters (Odds Ratio 4.6; 95% CI: 1.0-21.3). Serum albumin (Hazard Ratio 0.932, 95% CI: 0.9-1.0) and age (Hazard Ratio 1.04, 95% CI: 1.0-1.1) were found to be significant independent prognostic factors of mortality by Cox regression analysis. CONCLUSIONS: These results highlight the relevance of assessing the nutritional status of patients with hip fractures at the time of admission and emphasises the correlation between PEM and outcome in these patients.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Biological Markers/blood; Female; Follow-Up Studies; Geriatric Assessment/methods/statistics & numerical data; Hip Fractures/*blood/complications/surgery; Hospital Mortality; Humans; Length of Stay/statistics & numerical data; Lymphocyte Count/statistics & numerical data; Male; Nutritional Status; Odds Ratio; Patient Readmission/statistics & numerical data; Predictive Value of Tests; Prognosis; Protein-Energy Malnutrition/*blood/complications/diagnosis; Retrospective Studies; *Serum Albumin; Survival Analysis
ISSN:
1532-1983 (Electronic); 0261-5614 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Daly, Brendan Jen_GB
dc.contributor.authorWalsh, James Cen_GB
dc.contributor.authorQuinlan, John Fen_GB
dc.contributor.authorFalk, Gavin Aen_GB
dc.contributor.authorStapleton, Roberten_GB
dc.contributor.authorQuinlan, William Ren_GB
dc.contributor.authorO'Rourke, S Kieranen_GB
dc.date.accessioned2012-02-01T10:31:57Z-
dc.date.available2012-02-01T10:31:57Z-
dc.date.issued2012-02-01T10:31:57Z-
dc.identifier.citationClin Nutr. 2010 Feb;29(1):89-93. Epub 2009 Aug 11.en_GB
dc.identifier.issn1532-1983 (Electronic)en_GB
dc.identifier.issn0261-5614 (Linking)en_GB
dc.identifier.pmid19674819en_GB
dc.identifier.doi10.1016/j.clnu.2009.07.007en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207580-
dc.description.abstractBACKGROUND & AIMS: Hip fractures are a significant cause of mortality and morbidity in the elderly. Malnutrition is a significant contributor to this, however no consensus exists as to the detection or management of this condition. We hypothesise that results of admission serum albumin and total lymphocyte count (TLC), as markers of Protein Energy Malnutrition (PEM) can help predict clinical outcome in hip fracture patients aged over 60 years. METHODS: This retrospective study evaluated the nutritional status of patients with hip fractures using albumin and TLC assays and analysed their prognostic relevance. Clinical outcome parameters studied were delay to operation, duration of in-patient stay, re-admission and in-patient, 3- and 12-month mortality. RESULTS: Four hundred and fifteen hip fracture patients were evaluated. Survival data were available for 377 patients at 12 months. In-hospital mortality for PEM patients was 9.8%, compared with 0% for patients without. Patients with PEM had a higher 12-month mortality compared to patients who had normal values of both laboratory parameters (Odds Ratio 4.6; 95% CI: 1.0-21.3). Serum albumin (Hazard Ratio 0.932, 95% CI: 0.9-1.0) and age (Hazard Ratio 1.04, 95% CI: 1.0-1.1) were found to be significant independent prognostic factors of mortality by Cox regression analysis. CONCLUSIONS: These results highlight the relevance of assessing the nutritional status of patients with hip fractures at the time of admission and emphasises the correlation between PEM and outcome in these patients.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshBiological Markers/blooden_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshGeriatric Assessment/methods/statistics & numerical dataen_GB
dc.subject.meshHip Fractures/*blood/complications/surgeryen_GB
dc.subject.meshHospital Mortalityen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLength of Stay/statistics & numerical dataen_GB
dc.subject.meshLymphocyte Count/statistics & numerical dataen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNutritional Statusen_GB
dc.subject.meshOdds Ratioen_GB
dc.subject.meshPatient Readmission/statistics & numerical dataen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshPrognosisen_GB
dc.subject.meshProtein-Energy Malnutrition/*blood/complications/diagnosisen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.mesh*Serum Albuminen_GB
dc.subject.meshSurvival Analysisen_GB
dc.titleSerum albumin and total lymphocyte count as predictors of outcome in hip fractures.en_GB
dc.contributor.departmentDepartment of Orthopaedic Surgery, St. Vincent's University Hospital, Elm Park,, Dublin 4, Ireland. brendan.odaly@ucd.ieen_GB
dc.identifier.journalClinical nutrition (Edinburgh, Scotland)en_GB
dc.description.provinceLeinster-

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