TY - JOUR
T1 - Prediction of postoperative mortality in elderly patient with hip fractures
T2 - a single-centre, retrospective cohort study
AU - Niessen, Romain
AU - Bihin, Benoit
AU - Gourdin, Maximilien
AU - Yombi, Jean Cyr
AU - Cornu, Olivier
AU - Forget, Patrice
PY - 2018/12/3
Y1 - 2018/12/3
N2 - © 2018 The Author(s). Background: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable. Methods: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D 0 ) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models. Results: No correlation between gender, age, NLR D 0 or CRP D 0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D 0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D 0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance. Conclusions: Neither age, gender, NLR D 0 nor CRP D 0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.
AB - © 2018 The Author(s). Background: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable. Methods: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D 0 ) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models. Results: No correlation between gender, age, NLR D 0 or CRP D 0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D 0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D 0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance. Conclusions: Neither age, gender, NLR D 0 nor CRP D 0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.
KW - Biomarkers
KW - C-reactive protein
KW - Frailty
KW - Hip fractures
KW - Hospital mortality
UR - http://www.mendeley.com/research/prediction-postoperative-mortality-elderly-patient-hip-fractures-singlecentre-retrospective-cohort-s
U2 - 10.1186/s12871-018-0646-x
DO - 10.1186/s12871-018-0646-x
M3 - Article
SN - 0003-3022
VL - 18
JO - Anesthesiology
JF - Anesthesiology
IS - 1
M1 - 183
ER -