{"title":"老年髋部骨折患者入院时的前白蛋白浓度与死亡率之间的关系：一项队列研究","authors":"Shao-Hua Chen, Bin-Fei Zhang, Yu-Min Zhang","doi":"10.1007/s11657-024-01384-5","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">\n<i>Summary</i>\n</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>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, <i>P</i> < 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, <i>P</i> < 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, <i>P</i> = 0.5127).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>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.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study\",\"authors\":\"Shao-Hua Chen, Bin-Fei Zhang, Yu-Min Zhang\",\"doi\":\"10.1007/s11657-024-01384-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">\\n<i>Summary</i>\\n</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Objective</h3><p>To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fractures.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>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, <i>P</i> < 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, <i>P</i> < 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, <i>P</i> = 0.5127).</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>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.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11657-024-01384-5\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11657-024-01384-5","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
摘要 营养不良与髋部骨折患者的并发症和死亡率有关。前白蛋白可能比白蛋白更适合准确预测老年髋部骨折患者的预后。我们发现，前白蛋白浓度与老年髋部骨折患者的死亡率呈非线性关系，并观察到拐点效应。 Objective To evaluate the association between prealbumin concentration at admission and mortality in elderly patients with hip fracture.Methods在2015年1月至2019年9月期间筛查了老年髋部骨折患者。收集患者的人口统计学和临床特征。采用线性和非线性多变量 Cox 回归模型确定入院时白蛋白前浓度与死亡率之间的关系。所有分析均使用 EmpowerStats 和 R 软件进行。平均随访时间为 37.64 个月。前白蛋白浓度为 162.67 ± 43.2 mg/L。多变量 Cox 回归显示，前白蛋白浓度与老年髋部骨折患者的死亡率相关（危险比 [HR] = 0.95，95% 置信区间 [CI]：0.93-0.97，P<0.05）：0.93-0.97, P < 0.0001）。此外，在非线性关联中还观察到了拐点效应。拐点为 162.2 毫克/升。如果小于该拐点，则前白蛋白每增加 10 毫克/升，死亡风险就会降低 7%（HR = 0.93，95%CI：0.90-0.96，P < 0.0001）。结论入院时的前白蛋白浓度与老年髋部骨折的长期死亡率呈非线性关系，162.2 毫克/升可被视为死亡风险的预后因素。
The association between prealbumin concentration at admission and mortality in elderly patients with hip fractures: a cohort study
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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