前白蛋白对老年髋部骨折患者预后的预测价值

The Predictive Value of Prealbumin in the Prognosis of Elderly Patients with Hip Fractures

摘要: 介绍：评估前白蛋白对老年髋部骨折患者预后的预测价值。方法：收集西安红会医院在2015年1月至2019年9月期间收治的1196例老年髋部骨折患者的临床资料，然后对其进行了筛查，收集患者的人口统计学和临床特征，进行1:1匹配以后，采用线性和非线性的多变量Cox回归模型来确定入院时的前白蛋白浓度与死亡率之间的关系，所有分析均使用EmpowerStats和R软件进行。结果：这项前瞻性队列研究包括1196名符合研究标准的患者，平均随访时间为37.58个月。前白蛋白浓度为158.37 ± 42.99 mg/L，多变量Cox回归分析显示，前白蛋白浓度与老年髋部骨折患者的死亡率相关(风险比 = 0.96，95%置信区间：0.94~0.98，P < 0.0001)。与低前白蛋白组相比，中组降低了28%的死亡风险(HR = 0.72, 95% CI: 0.59~0.87, P = 0.0007)，高组降低了32%的死亡风险(HR = 0.68, 95% CI: 0.56~0.83, P = 0.0002)。此外，对线性趋势(P表示趋势)的检验在不同的模型中也显示出线性相关。结论：老年髋部骨折患者的长期死亡率与前白蛋白浓度之间存在线性相关，前白蛋白对老年髋部骨折患者的预后具有预测价值。

Abstract: Introduction: To evaluate the predictive value of prealbumin for outcome in elderly patients with hip fractures. Methods: Clinical data of 1196 elderly hip fracture patients admitted to Xi’an Red So-ciety Hospital between January 2015 and September 2019 were then screened for demographic and clinical characteristics. After 1:1 matching, linear and nonlinear multivariable Cox regression models were used to determine the relationship between prealbumin concentration and mortality at admission, and all analyses were performed using EmpowerStats and R software. Results: This prospective cohort study included 1,196 patients who met the study criteria, with a mean follow-up time of 37.58 months. The prealbumin concentration was 158.37 ± 42.99 mg/L, and multivariate Cox regression analysis showed that the prealbumin concentration was associated with mortality in elderly hip fractures (hazard ratio = 0.96, 95% confidence interval: 0.94~0.98, P < 0.0001). The middle group reduced the risk of death by 28% (HR = 0.72, 95% CI: 0.59~0.87, P = 0.0007), and the high group reduced the risk of death by 32% (HR = 0.68, 95% CI: 0.56~0.83, P = 0.0002). In addi-tion, tests of linear trends (P indicates the trend) also showed a linear correlation in different mod-els. Conclusion: The prealbumin concentrations at admission were linearly associated with long-term mortality in geriatric hip fractures, and prealbumin has predictive value for the progno-sis of elderly patients with hip fracture.