Prealbumin Adjusted Prognostic Nutritional Index May Predict the Postoperative Survival and Free Walking Abilities of Patients with Hip Fractures: A Multi-Center Follow-Up Study.

Background: This multi-center study aims to develop and validate the Prealbumin-adjusted Prognostic Nutritional Index (PAPNI), hypothesizing that it would enhance prognostic prediction for hip fracture patients compared to traditional indices.

Methods: Data from 771 patients (Cohort 1) and 673 patients (Cohort 2) were retrospectively analyzed. The PAPNI was formulated by substituting albumin with prealbumin in the Prognostic Nutritional Index (PNI) formula, with its weight optimized using receiver operating characteristic (ROC) curves. All individuals were followed up for 1 year. The relationships between PAPNI and outcomes were explored.

Results: In both cohorts, PAPNI demonstrated superior predictive accuracy for 1-year mortality and free walking ability compared to PNI, prealbumin, and lymphocyte count alone. Patients with low PAPNI exhibited significantly higher mortality rates and lower free walking rates. Multivariate analyses confirmed PAPNI as an independent predictor for outcomes of hip fracture.

Conclusion: PAPNI, incorporating prealbumin, offers a more accurate and convenient method for predicting postoperative survival and functional recovery of hip fractures, providing a basis for early nutritional intervention.