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The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study

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Abstract

Summary

Malnutrition is associated with complications and mortality in patients of hip fracture. Prealbumin may be more suitable than albumin to accurately predict the prognosis of hip fracture in elderly patients. We found that prealbumin concentration was nonlinearly associated with mortality in elderly patients with hip fracture, and an inflection point effect was observed.

Objective

To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures.

Methods

Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between prealbumin concentration at admission and mortality. All analyses were performed using EmpowerStats and the R software.

Results

This cohort study included 2387 patients who met the study criteria. The mean follow-up was 37.64 months. The prealbumin concentration was 162.67 ± 43.2 mg/L. Multivariate Cox regression showed that prealbumin concentration was associated with mortality in geriatric patients with hip fracture (hazard ratio [HR] = 0.95, 95% confidence intervals [CI]: 0.93–0.97, P < 0.0001). In addition, an inflection point effect was observed in the nonlinear association. The inflection point was 162.2 mg/L. If it is less than this inflection point, then every 10 mg/L increase in prealbumin was associated with a 7% reduction in the risk of death (HR = 0.93, 95%CI: 0.90–0.96, P < 0.0001). When greater than the inflection point, there was no difference in the risk of death (HR = 0.99, 95%CI: 0.95–1.03, P = 0.5127).

Conclusion

The prealbumin concentrations at admission were nonlinearly associated with long-term mortality in geriatric hip fractures, and 162.2 mg/L could be considered a prognostic factor of mortality risk.

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Data availability

The data was implemented by Xi’an Honghui Hospital. According to relevant regulations, the data could not be shared, but could be requested from correspondence author.

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Author information

Authors and Affiliations

  1. Department of Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Beilin District, No. 555 Youyi East Road, Xi’an, 710054, Shaanxi Province, China

    Shao-Hua Chen, Bin-Fei Zhang & Yu-Min Zhang

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  1. Shao-Hua Chen
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  2. Bin-Fei Zhang
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  3. Yu-Min Zhang
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Contributions

According to the definition given by the International Committee of Medical Journal Editors (ICMJE), the authors listed above qualify for authorship based on making one or more of the substantial contributions to the intellectual content of the following:

Conceived and designed the study: Bin-Fei Zhang, Yu-Min Zhang.

Performed the study: Bin-Fei Zhang, Shao-Hua Chen.

Analyzed the data: Bin-Fei Zhang.

Wrote the manuscript: Shao-Hua Chen.

Corresponding author

Correspondence to Bin-Fei Zhang.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Honghui Hospital, Xi’an Jiaotong University (No. 202201009).

Registered information

This study is registered in the website of Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).

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The work described has not been published before (except in the form of an abstract or as part of a published lecture, review, or thesis); it is not under consideration for publication elsewhere; and its publication has been approved by all co-authors.

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The authors declare no competing interests.

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Chen, SH., Zhang, BF. & Zhang, YM. The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study. Arch Osteoporos 19, 27 (2024). https://doi.org/10.1007/s11657-024-01384-5

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