Hypoalbuminemia Leads to An Increased Risk Of Mortality And Re-Operation Within 3-Months In Patients 75< Years Of Age After Surgery For Hip Fractures

Abstract

Background: The focus of this study is to ascertain a baseline nutritional level of adults 75 years old who are hospitalized for hip fracture surgery, and to assess the effects on the mortality rates and post-operative complications that require re-operation within 3 months of the initial surgery. Material and Methods: A total of 240 patients having surgery for fractured hips during 2017-2019 were identified. Patients' characteristics, including pre-operative laboratory findings, complications and reoperation rates were assessed. Multivariate logistic regression analysis was used to establish the effect of hypoalbuminemia and total lymphocyte count on the rates of 3-month post-operative complications, re-operation and mortality. Results: Among patients studied, 153 had hypoalbuminemia (albumin levels <3.5 g/dL), and 87 showed normal albumin levels (albumin levels ³3.5 g/dL). Patients in the hypoalbuminemia group were likely to be functionally dependent (p = 0.002) and had higher Charlson comorbidity scores (p = 0.006) than their counterparts. The American Society of Anesthesiologists score and albumin levels were significant predictors of re-operation (p = 0.013, p = 0.039). The increase in age by 1 year, albumin level <3.5 g/dL, and lymphocyte count <1500 cells/mm³ were associated with increased mortality rates (p = 0.012, p = 0.004, p = 0.002). Conclusion:  Malnutrition is high in patients with hip fractures. In this study, hypoalbuminemia and lymphocyte count (<1500 cells/mm³) were directly associated with post-operative mortality rates and complications that required re-operation within 3 months of initial surgery.