Abstract
BACKGROUND: Hip fractures in the elderly have a significant impact, both in terms of human suffering and healthcare costs. Little is known about preoperative markers that may predict mortality following geriatric hip fracture surgery. This study aimed to investigate potential risk factors, including the C-reactive protein to albumin ratio (CAR), for mortality in elderly patients undergoing surgery for hip fracture. METHODS: A total of 180 elderly patients with hip fractures were included in this cross-sectional study. The patients were divided into two groups: the survival group and the deceased group. Serum levels of C-reactive protein (CRP) and albumin, as well as the CAR, were compared between the two groups to determine whether CAR is a predictor of mortality in elderly patients undergoing hip fracture surgery. The Mini Nutritional Assessment-Short Form was used to evaluate the nutrition status of the patients. RESULTS: The mean age of the 180 participants was 78 years, and 53.3% were female. A statistically significant difference was observed between the two groups in terms of the duration of hospital and intensive care unit stay (p<0.05). According to the receiver operating characteristic (ROC) analysis, with a cutoff value of >0.15, CAR could predict mortality after geriatric hip fracture surgery with a sensitivity of 74% and a specificity of 53%. The area under the ROC curve (AUC) for CAR was 0.67 (95% confidence interval [CI]: 0.57-0.76, p<0.001). CAR and the time between fracture and surgery were found to be independent predictors of mortality (p=0.003, odds ratio [OR]=1.37 and p=0.044, OR=1.33, respectively). CONCLUSION: An elevated preoperative CAR is associated with a significantly increased risk of mortality in elderly patients undergoing hip fracture surgery. Additionally, a shorter time to surgery was associated with lower mortality in these patients.