Association Between High-Sensitivity Troponin T on Admission and Organ Dysfunction During Hospitalization in Patients Aged 80 Years and Older with Hip Fracture: A Single-Centered Prospective Cohort Study

Abstract

Background

Prognostic evaluation of elderly patients with hip fracture is an issue that has been highly concerned by clinicians. Only a few studies have focused on organ dysfunction after hip fracture in the elderly. This study aimed to investigate the association between high-sensitivity troponin T (hs-TnT) at admission and organ dysfunction during hospitalization in elderly patients with hip fracture.

Methods

We enrolled 168 patients with hip fracture who were aged 80 years and older at Geriatric Orthopaedic Center of Sichuan Provincial Orthopedic Hospital between January 2020 and August 2020. Baseline characteristics, perioperative information, and short-term clinical outcomes were analyzed.

Results

Of the 208 patients admitted during the study period, 168 met the inclusion criteria; of these, 91 (54.2%) had higher hs-TnT than the 99th percentile in the normal population. After adjustment for confounders, elevated hs-TnT was independently associated with multiple organ dysfunction syndrome in the elderly (MODSE) (adjusted OR, 5.76; 95% CI, 1.74–19.10; P = 0.004), heart dysfunction (adjusted OR, 7.48; 95% CI, 2.17–25.82; P = 0.001), MODS severity score > 3 (adjusted OR, 5.22; 95% CI, 1.32–20.60; P = 0.018), and length of hospital stay > 14 days (adjusted OR, 2.38; 95% CI, 1.05–5.36; P = 0.037).

Conclusion

Increased hs-TnT on admission is an independent risk factor for MODSE after hip fracture in patients aged 80 years and older. Effective measures should be applied to avoid progression of MODSE from pre-failure stage to failure stage.

Keywords:

• high-sensitivity troponin T
• hip fracture
• multiple organ dysfunction syndrome in the elderly
• short-term outcomes

Ethics Approval and Consent to Participate

The study was approved by the Ethics Commission of Sichuan Orthopaedic Hospital (approval number, KY2020-032-01) and the requirement for informed consent was exempted. We confirmed that all procedures followed were in accordance with the Helsinki Declaration and patient data was maintained with confidentiality.

Disclosure

The authors report no conflicts of interest in this work.