Value of routine blood tests for prediction of mortality risk in hip fracture patients

Abstract

Background There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission.

Methods 792 hip fracture patients were included prospectively; blood tests were taken on admission. Follow-up data on mortality were obtained from the civil registration system. Patients were divided into 2 groups based on whether they had survived at least 90 days after the hip fracture. To estimate which laboratory tests could be used to predict outcome, we used receiver operation characteristic (ROC) curves.

Results 3-month mortality could be predicted with 69% accuracy from the level of plasma creatinine in standard admission blood tests. The mortality in patients with elevated levels of creatinine was almost 3-fold that of the patients with normal creatinine. Mortality was also associated with age, low blood hemoglobin, high plasma potassium, and low plasma albumin levels.

Interpretation Our findings could be of use in identifying patients who might benefit from increased attention perioperatively.

BD, HJ, JL, MM, and OP designed the study. HJ, HW, and TR gathered the data. HJ and OB analyzed the data. MM wrote the initial draft and BD, HJ, JL, SM, HW, OP, and TR revised it.

We would like to thank the Toyota foundation and Grosserer L. F. Foghts foundation.

No competing interests declared.