Scholarlink

Background <p>Early postoperative mortality remains a major challenge in elderly patients with intertrochanteric hip fractures. Identifying simple and reliable preoperative biomarkers is essential for short-term risk stratification. The blood urea nitrogen-to-albumin ratio (BAR) integrates metabolic stress, renal perfusion, and nutritional status; however, its prognostic value in orthopedic trauma has not been fully clarified.</p> Methods <p>This retrospective cohort study included 514 patients aged ≥ 65 years who underwent surgical treatment for intertrochanteric femur fractures. Preoperative BAR and other inflammatory biomarkers—including CRP-to-albumin ratio (CAR), fibrinogen-to-albumin ratio (FAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR)—were analyzed. Thirty-day mortality was evaluated using receiver operating characteristic (ROC) analysis and multivariable logistic regression.</p> Results <p>Thirty-day mortality occurred in 54 patients (10.5%). Non-survivors had significantly higher inflammatory and metabolic biomarker levels and lower albumin levels compared with survivors (all <i>p</i> &lt; 0.05). BAR demonstrated the highest discriminative ability for predicting 30-day mortality <b>(</b>AUC = 0.82), with an optimal cut-off value of 9.0 (sensitivity 79%, specificity 72%). In multivariable analysis, BAR ≥ 9.0 remained the only independent predictor of mortality (adjusted OR 2.68; 95% CI 1.34–5.34; <i>p</i> = 0.006).</p> Conclusions <p>Preoperative BAR is an independent biomarker for predicting early mortality in elderly patients with intertrochanteric hip fractures. Its simplicity and routine clinical availability support its potential use in preoperative risk stratification. Prospective multicenter studies are needed to confirm these findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The preoperative BUN-to-albumin ratio predicts early mortality after geriatric intertrochanteric fracture surgery: a retrospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月27日

查看全文
  • Bahri Bozgeyik,
  • İlkan Kişi,
  • Ramazan Erol,
  • Emre Kırkgöz,
  • Nevzat Gönder,
  • Erman Öğümsöğütlü

摘要

Background

Early postoperative mortality remains a major challenge in elderly patients with intertrochanteric hip fractures. Identifying simple and reliable preoperative biomarkers is essential for short-term risk stratification. The blood urea nitrogen-to-albumin ratio (BAR) integrates metabolic stress, renal perfusion, and nutritional status; however, its prognostic value in orthopedic trauma has not been fully clarified.

Methods

This retrospective cohort study included 514 patients aged ≥ 65 years who underwent surgical treatment for intertrochanteric femur fractures. Preoperative BAR and other inflammatory biomarkers—including CRP-to-albumin ratio (CAR), fibrinogen-to-albumin ratio (FAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR)—were analyzed. Thirty-day mortality was evaluated using receiver operating characteristic (ROC) analysis and multivariable logistic regression.

Results

Thirty-day mortality occurred in 54 patients (10.5%). Non-survivors had significantly higher inflammatory and metabolic biomarker levels and lower albumin levels compared with survivors (all p < 0.05). BAR demonstrated the highest discriminative ability for predicting 30-day mortality (AUC = 0.82), with an optimal cut-off value of 9.0 (sensitivity 79%, specificity 72%). In multivariable analysis, BAR ≥ 9.0 remained the only independent predictor of mortality (adjusted OR 2.68; 95% CI 1.34–5.34; p = 0.006).

Conclusions

Preoperative BAR is an independent biomarker for predicting early mortality in elderly patients with intertrochanteric hip fractures. Its simplicity and routine clinical availability support its potential use in preoperative risk stratification. Prospective multicenter studies are needed to confirm these findings.