Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit
<i>Background and Objectives</i>: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. T...
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2025-03-01
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| author | Metin Kilinc Enes Çelik Ibrahim Demir Semih Aydemir Hakan Akelma |
| author_facet | Metin Kilinc Enes Çelik Ibrahim Demir Semih Aydemir Hakan Akelma |
| author_sort | Metin Kilinc |
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| description | <i>Background and Objectives</i>: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. <i>Materials and Methods</i>: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. <i>Results</i>: The mean age of the patients was 76.3 ± 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (<i>p</i> < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (<i>p</i> < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (<i>p</i> < 0.001). <i>Conclusions</i>: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management. |
| format | Article |
| id | doaj-art-006fb71a2bd140ed9c2814bff1c95c8b |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-006fb71a2bd140ed9c2814bff1c95c8b2025-08-20T03:43:14ZengMDPI AGMedicina1010-660X1648-91442025-03-0161353810.3390/medicina61030538Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care UnitMetin Kilinc0Enes Çelik1Ibrahim Demir2Semih Aydemir3Hakan Akelma4Department of Anesthesiology and Reanimation, Faculty of Medicine, Mardin Artuklu University, Mardin 47200, TurkeyDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Mardin Artuklu University, Mardin 47200, TurkeyDepartment of Anesthesiology and Reanimation, Mardin Training and Research Hospital, Mardin 47200, TurkeyDepartment of Anesthesiology and Reanimation, Yenimahalle Training and Research Hospital, University of Yıldırım Beyazit, Ankara 06370, TurkeyDepartment of Anesthesiology and Reanimation, Faculty of Medicine, Mardin Artuklu University, Mardin 47200, Turkey<i>Background and Objectives</i>: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. <i>Materials and Methods</i>: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. <i>Results</i>: The mean age of the patients was 76.3 ± 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (<i>p</i> < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (<i>p</i> < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (<i>p</i> < 0.001). <i>Conclusions</i>: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management.https://www.mdpi.com/1648-9144/61/3/538postoperative femur fractureICU mortalityinflammatory markersAPACHE II scorealbuminCRP |
| spellingShingle | Metin Kilinc Enes Çelik Ibrahim Demir Semih Aydemir Hakan Akelma Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit Medicina postoperative femur fracture ICU mortality inflammatory markers APACHE II score albumin CRP |
| title | Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit |
| title_full | Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit |
| title_fullStr | Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit |
| title_full_unstemmed | Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit |
| title_short | Association of Inflammatory and Metabolic Markers with Mortality in Patients with Postoperative Femur Fractures in the Intensive Care Unit |
| title_sort | association of inflammatory and metabolic markers with mortality in patients with postoperative femur fractures in the intensive care unit |
| topic | postoperative femur fracture ICU mortality inflammatory markers APACHE II score albumin CRP |
| url | https://www.mdpi.com/1648-9144/61/3/538 |
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