PURPOSE To analyse a wide set of routine laboratory parameters at admission to predict mortality within 30 post-operative days in elderly patients with hip fracture, as well as calculate the critical values of those biomarkers. METHOD Data of 994 patients older than 65 years with hip fracture were analysed of which 89 (8.2%) died within 30 post-operative days. Variables described in the literature with potential influence on early mortality were collected, including demographics, fracture type, American Society of Anesthesiologists score, Charlson's comorbidity index and pre-operative Hodkinson's mental test and the Katz index for activities of daily living. In addition, an exhaustive collection of biomarkers from routine blood testing at admission was performed. Critical levels of biomarkers were calculated by the method of area under ROC curve. RESULTS At admission, early mortality group had significantly higher Charlson's index (p = 0.001) and lower the Katz index (p = 0.001). The surgical delay also was significantly longer in that group (p = 0.001). In univariate analyses, serum concentration at admission of total protein (p = 0.004), albumin (p = 0.001), sodium (p = 0.001), and parathyroid hormone (PTH) (p = 0.001) were significantly different between both groups. In multivariate analysis, serum albumin < 2.9 g/dL (p = 0.013), sodium < 127 mEq/L (p = 0.035) and PTH > 65 pg/mL (p = 0.005) were predictors of early mortality. The three biomarkers together accounted for 67% of the variability in early mortality. CONCLUSION The association of altered levels at admission of serum concentration of albumin, sodium and PTH was predictor of early mortality following hip fracture surgery in elderly patients.

中文翻译：

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血清中白蛋白，钠和甲状旁腺激素水平的改变可预测老年人髋部骨折手术后的早期死亡率。

目的分析入院时的一系列常规实验室参数，以预测老年髋部骨折患者术后30天内的死亡率，并计算这些生物标志物的临界值。方法分析了994名65岁以上髋部骨折患者的数据，其中89例（8.2％）在术后30天内死亡。收集了文献中描述的可能对早期死亡率产生影响的变量，包括人口统计学，骨折类型，美国麻醉医师学会评分，查尔森合并症指数和术前霍德金森心理测验以及日常生活活动的卡茨指数。另外，从入院时的常规血液测试中详尽收集了生物标志物。通过ROC曲线下的面积方法计算生物标志物的临界水平。结果入院时，早期死亡率组的Charlson指数（p = 0.001）显着较高，而Katz指数（p = 0.001）较低。该组的手术延迟也明显更长（p = 0.001）。在单变量分析中，两组患者在接受总蛋白（p = 0.004），白蛋白（p = 0.001），钠（p = 0.001）和甲状旁腺激素（PTH）（p = 0.001）时的血清浓度显着不同。在多变量分析中，血清白蛋白<2.9 g / dL（p = 0.013），钠<127 mEq / L（p = 0.035）和PTH> 65 pg / mL（p = 0.005）是早期死亡率的预测指标。这三种生物标志物共占早期死亡率变异性的67％。