Haematological indices as surrogate markers of factors affecting mortality after hip fracture

This study investigated the relationship between different components of the full blood count, such as haemoglobin (Hb), total white cell count, total lymphocyte count on admission and total neutrophil count as possible surrogate markers of conditions that lead to increased mortality in hip-fracture patients. A total of 791 patients were studied with 81.2% being females. The 1-year mortality was 26.4% (32.9% in males compared with 24.9% in females). A significant increase in mortality was seen in anaemic patients, especially with Hb 80–100 g l−1 (1-year mortality was 49.2%, p-value < 0.001) and patients with lymphocyte count ≤1.1 × 109 l−1 (33.2% mortality, p-value < 0.0001). There was no relationship between total white cell count or neutrophil count and mortality. This information clearly suggests that Hb and total lymphocyte counts may be surrogate markers for increased mortality after a hip fracture and can be used for audit purposes to adjust for different case mixes between groups.