ReviewRoutine blood tests as predictors of mortality in hip fracture patients

ObjectiveThe aim of this study was to assess the evidence for the association between different biochemical markers at admission and mortality through a meta-analysis.Data sourcesPubMed-, Embase-, Cochran Library and the Web of Knowledge were searched for cohort studies.Study selectionEligible studies were observational studies with a study population larger than 150 subjects, a mean age above 60 years and a study duration below 730 days.Data extractionCharacteristics of studies and outcomes of all-cause mortality were extracted from the retrieved articles. Data were pooled across studies for the individual biomarker using random- or fixed-effect analysis.Data synthesis15 eligible studies of 5 different markers on mortality were studied. The following markers were found to be of prognostic value on mortality in hip fracture patients: low haemoglobin (odds ratio, 2.78; 95% confidence interval, 2.17-3.55; P < 0.00001, 3148 subjects included), low total lymphocyte count, TLC (odds ratio, 2.60; 95% confidence interval, 1.61-4.20; P < 0.00001, 1689 subjects included), low albumin (odds ratio, 1.83; 95% confidence interval, 1.31-2.56; P = 0.0004, 1680 subjects included), low albumin/low TLC (odds ratio, 3.00; 95% confidence interval, 1.81-4.99; P < 0.0001, 704 subjects included), low albumin/high TLC (odds ratio, 3.39; 95% confidence interval, 1.83-6.29; P = 0.0001, 704 subjects included), high creatinine (odds ratio, 1.58; 95% confidence interval, 1.25-1.99; P = 0.0001, 3761 subjects included), and high PTH (odds ratio, 15.43; 95% confidence interval, 3.60-66.14; P = 0.0002, 525 subjects included).ConclusionBiochemical markers at admission are valid predictors of mortality in hip fracture patients.