Predictive value of frailty and nutritional risk screening for in-hospital complications in elderly hip fracture patients.

Abstract

Background and objectives: To investigate the underlying inflammatory markers of frailty and evaluate the predictive power of frailty and nutritional risk screening (NRS) for in-hospital complications in elderly patients with hip fractures.

Methods and study design: A total of 233 elderly patients with hip fractures partic-ipated in the study. Frailty and nutritional risk screening was performed on all participants, who were then divided into frail ('frail only' and 'frail and malnourished') and non-frail ('robust' and 'malnourished only') cohorts. The clinical data were collected for all participants, and in-hospital complications were followed up.

Results: Among the patients, 39.9% were frail, 26.2% were malnourished and 15.5% were both frail and malnourished. The frail group were older and had higher Charlson comorbidity index (CCI) scores, systemic immune-inflammation index (SII) levels and fibrinogen levels than patients in the other cohorts. After adjusting for age, CCI and nutritional status,the SII was an independent predictor of frailty, indicating its role as an inflammatory marker of frailty. Frail patients had significantly higher rates of total complications, lower limb deep vein thrombosis (DVT), infections and cardiac complications than the non-frail group. Patients who were both frail and malnourished had a 1.98 times higher risk of nosocomial infection than those who were only frail.

Conclusions: The SII is a significant predictor of frailty, and it may be used as an inflammatory marker of frailty. The fatigue, resistance, ambulation, illnesses and loss of weight scale can effectively predict the in-hospital complications of elderly patients with hip fractures.