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Article

Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture

1
Departments of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra 2605, Australia
2
Departments of Orthopaedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia
3
Medical School, Australian National University, Canberra 2605, Australia
4
Department of Gastroenterology, Frankston Hospital, Peninsula Health, Melbourne 3199, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(22), 6784; https://doi.org/10.3390/jcm11226784
Submission received: 27 October 2022 / Revised: 9 November 2022 / Accepted: 11 November 2022 / Published: 16 November 2022

Abstract

Aim: To evaluate the prognostic impact at admission of 10 biochemical indices for prediction postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In 1273 consecutive patients with HF (mean age 82.9 ± 8.7 years, 73.5% women), clinical and laboratory parameters were collected prospectively, and outcomes were recorded. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were preformed, the number needed to predict (NNP) outcome was calculated. Results: Age ≥ 80 years and IHD were the most prominent clinical factors associated with both PMI (with cardiac troponin I rise) and in-hospital death. PMI occurred in 555 (43.6%) patients and contributed to 80.3% (49/61) of all deaths (mortality rate 8.8% vs. 1.9% in non-PMI patients). The most accurate biochemical predictive markers were parathyroid hormone > 6.8 pmol/L, urea > 7.5 mmol/L, 25(OH)vitamin D < 25 nmol/L, albumin < 33 g/L, and ratios gamma-glutamyl transferase (GGT) to alanine aminotransferase > 2.5, urea/albumin ≥ 2.0 and GGT/albumin ≥ 7.0; the AUC for developing PMI ranged between 0.782 and 0.742 (NNP: 1.84–2.13), the AUC for fatal outcome ranged from 0.803 to 0.722, (NNP: 3.77–9.52). Conclusions: In HF patients, easily accessible biochemical indices at admission substantially improve prediction of hospital outcomes, especially in the aged >80 years with IHD.
Keywords: hip fracture; mortality; myocardial injury; biochemical markers; predictors hip fracture; mortality; myocardial injury; biochemical markers; predictors

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MDPI and ACS Style

Fisher, A.; Srikusalanukul, W.; Fisher, L.; Smith, P.N. Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture. J. Clin. Med. 2022, 11, 6784. https://doi.org/10.3390/jcm11226784

AMA Style

Fisher A, Srikusalanukul W, Fisher L, Smith PN. Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture. Journal of Clinical Medicine. 2022; 11(22):6784. https://doi.org/10.3390/jcm11226784

Chicago/Turabian Style

Fisher, Alexander, Wichat Srikusalanukul, Leon Fisher, and Paul N. Smith. 2022. "Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture" Journal of Clinical Medicine 11, no. 22: 6784. https://doi.org/10.3390/jcm11226784

APA Style

Fisher, A., Srikusalanukul, W., Fisher, L., & Smith, P. N. (2022). Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture. Journal of Clinical Medicine, 11(22), 6784. https://doi.org/10.3390/jcm11226784

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