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Prealbumin as a nutrition status indicator may be associated with outcomes of geriatric hip fractures: a propensity score matching and 1-year follow-up study

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Abstract

Aim

Nutrition status may affect bone metabolism and regeneration in the elderly. However, few studies reported a sensitive nutrition indicator or evaluation tool for geriatric hip fractures. This study aimed to explore if prealbumin (PAB), a critical nutrition-related protein, is related to the prognosis of hip fractures.

Methods

Patients with hip fractures who met the inclusion criteria were included in our study. Geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) were calculated. Propensity score matching (PSM) was used to reduce the influence of confounding factors and ROC curves were conducted to explore the optimal cutoff points of PAB and to compare the prognostic value between GNRI, PNI, and PAB. Then Cox and Logistics analyses were performed to identify the relation between PAB and outcomes of hip fractures.

Results

Out of the 546 patients enrolled in this study, 91 patients died within one year. After a 1:1 PSM, the patients with less than 1-year survival had significantly lower PAB (p < 0.001) than those who were still alive at one year. ROC curves showed that the PAB may sensitively predict 6-month survival (AUROC: 0.695), 1-year survival (AUROC: 0.696), and 1-year-free walking ability (AUROC: 0.642). Logistics analysis showed that low PAB may be an independent risk factor for survival and 1-year-free walking ability.

Conclusion

Low levels of PAB may be associated with poor survival and walking abilities of older patients after surgery for hip fracture.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge Jiaming Wang, Meng Li, and Xiao Fu for their contributions to data management and database establishment.

Funding

Leading Talents Training Program of Pudong New Area Health Commission (Grant ID: PWR 12020–06).

Author information

Author notes

  1. Mingchong Liu and Shengchao Ji contributed equally to this work.

Authors and Affiliations

  1. Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China

    Mingchong Liu, Shengchao Ji, Chensong Yang, Ning Han, Yutao Pan, Xian Xu & Guixin Sun

  2. Department of Center for Orthopedic Repair and Reconstruction, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, 202150, People’s Republic of China

    Tianhao Zhang & Jian Lin

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  1. Mingchong Liu
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Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Corresponding authors

Correspondence to Jian Lin or Guixin Sun.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical standards

The study was performed according to the Declaration of Helsinki and was approved by the Institutional Ethics Committee of East Hospital.

Informed consent

Informed consent was obtained from all participants enrolled in this study.

Human and animal rights statement

This study was an observational study using the data of patients admitted to the Department of Traumatology, Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China.

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Liu, M., Ji, S., Yang, C. et al. Prealbumin as a nutrition status indicator may be associated with outcomes of geriatric hip fractures: a propensity score matching and 1-year follow-up study. Aging Clin Exp Res 34, 3005–3015 (2022). https://doi.org/10.1007/s40520-022-02243-4

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