The effect of blood albumin and total lymphocyte count on short-term results in elderly patients with hip fractures.
BACKGROUND
A study was performed to determine the effects of blood albumin and total lymphocyte count on the postoperative one-year period in 74 elderly hip fracture patients.


METHODS
In 2006, 74 patients (52 female, 22 male) with hip fracture who were 65 years of age or older were included in the study. Admission albumin levels and total lymphocyte counts were recorded. The outcomes examined were mortality, length of hospital stay and ambulatory ability. Ambulatory ability was assessed according to Parkland and Palmer criteria.


RESULTS
There were 61 patients aged 65-84 years, and 13 patients aged 85-105 years. Forty-one patients (55.4%) had hypoalbuminemia and 23 patients (31.1%) had low total lymphocyte count. Low albumin and total lymphocyte counts were associated with higher mortality (p = 0.011). Patients with low albumin levels had longer length of hospital stay (p = 0.002). Patients with normal albumin and total lymphocyte counts had higher mobility score meaning better function (p = 0.012). Multivariate analysis yielded that low total lymphocyte count, American Society of Anesthesiologists (ASA) 3-4 and female gender remained significant independent predictors of one-year mortality. No single blood parameter was found to be effective on ambulatory status.


CONCLUSIONS
Risk of mortality in elderly hip fracture patients increases with female gender, ASA 3-4 and low total lymphocyte counts. Hypoalbuminemia is associated with longer hospitalization. Identification of these risk factors can help in the case management for a more favorable outcome.
Oztürk
Alpaslan
A
Department of Orthopaedics and Traumatology, Bursa High Specialty Training and Research Hospital, Bursa, Turkey. ozturkalp@mynet.com
Ozkan
Yüksel
Y
Akgöz
Semra
S
Yalçin
Nazan
N
Aykut
Serkan
S
Ozdemir
Mehmet Recai
MR
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000276:immunology / Q000401:mortality* / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012709:Serum Albumin / Q000494:pharmacology*; D016019:Survival Analysis; D017741:Survivors
D000925:Anticoagulants; D017984:Enoxaparin; D012709:Serum Albumin