Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures

Abstract Postoperative pneumonia (POP) is a common complication after hip fracture surgery and is associated with increased mortality and other complications in elderly patients. This study aims to evaluate biomarkers, especially the glucose-albumin ratio (GAR), for predicting POP in elderly hip fra...

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Main Authors: Wanyun Tang, Xiaomin Ni, Wei Yao, Wei Wang, Yuhao Li, Qiaomei Lv, Wenbo Ding, Renjian He
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-60390-2
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author Wanyun Tang
Xiaomin Ni
Wei Yao
Wei Wang
Yuhao Li
Qiaomei Lv
Wenbo Ding
Renjian He
author_facet Wanyun Tang
Xiaomin Ni
Wei Yao
Wei Wang
Yuhao Li
Qiaomei Lv
Wenbo Ding
Renjian He
author_sort Wanyun Tang
collection DOAJ
description Abstract Postoperative pneumonia (POP) is a common complication after hip fracture surgery and is associated with increased mortality and other complications in elderly patients. This study aims to evaluate biomarkers, especially the glucose-albumin ratio (GAR), for predicting POP in elderly hip fracture patients. A total of 1279 elderly patients admitted to our hospital with hip fractures were included. We assessed 29 biomarkers and focused on GAR to determine its prognostic and predictive value for POP. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for POP, adjusting for potential confounders. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cut-off of GAR for predicting POP. Among the biomarkers and combinations assessed, GAR demonstrated superior predictive capability for POP in elderly hip fracture patients. ROC analyses showed moderate predictive accuracy of GAR for POP, with an area under the curve of 0.750. Using the optimal cut-off of 0.175, the high GAR group was significantly associated with increased odds of POP (adjusted OR 2.14, 95%, CI 1.50–3.05). These associations remained significant after propensity score matching and subgroup analyses. Dose–response relationships between GAR and POP were observed. In conclusion, GAR may be a promising biomarker to predict POP risk in elderly hip fracture patients. Further studies are warranted to validate its clinical utility. However, this study has certain limitations, including its retrospective design, potential for selection bias due to the exclusion criteria, and the single-center nature of the study, which should be addressed in future prospective, multicenter studies.
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spelling doaj-art-33dee82a31634690a10bc5374e0ef3602025-08-20T02:13:39ZengNature PortfolioScientific Reports2045-23222024-11-0114111110.1038/s41598-024-60390-2Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fracturesWanyun Tang0Xiaomin Ni1Wei Yao2Wei Wang3Yuhao Li4Qiaomei Lv5Wenbo Ding6Renjian He7Department of Orthopedics, Zigong First People’s HospitalDepartment of Orthopedics, Zigong Fourth People’s HospitalDepartment of Orthopedics, Dandong Central Hospital, China Medical UniversityDepartment of Orthopedics, Dandong Central Hospital, China Medical UniversityDepartment of Orthopedics, Dandong Central Hospital, China Medical UniversityDepartment of Oncology, Dandong Central Hospital, China Medical UniversityDepartment of Orthopedics, Dandong Central Hospital, China Medical UniversityDepartment of Orthopedics, Zigong First People’s HospitalAbstract Postoperative pneumonia (POP) is a common complication after hip fracture surgery and is associated with increased mortality and other complications in elderly patients. This study aims to evaluate biomarkers, especially the glucose-albumin ratio (GAR), for predicting POP in elderly hip fracture patients. A total of 1279 elderly patients admitted to our hospital with hip fractures were included. We assessed 29 biomarkers and focused on GAR to determine its prognostic and predictive value for POP. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for POP, adjusting for potential confounders. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cut-off of GAR for predicting POP. Among the biomarkers and combinations assessed, GAR demonstrated superior predictive capability for POP in elderly hip fracture patients. ROC analyses showed moderate predictive accuracy of GAR for POP, with an area under the curve of 0.750. Using the optimal cut-off of 0.175, the high GAR group was significantly associated with increased odds of POP (adjusted OR 2.14, 95%, CI 1.50–3.05). These associations remained significant after propensity score matching and subgroup analyses. Dose–response relationships between GAR and POP were observed. In conclusion, GAR may be a promising biomarker to predict POP risk in elderly hip fracture patients. Further studies are warranted to validate its clinical utility. However, this study has certain limitations, including its retrospective design, potential for selection bias due to the exclusion criteria, and the single-center nature of the study, which should be addressed in future prospective, multicenter studies.https://doi.org/10.1038/s41598-024-60390-2Hip fracturePneumoniaGlucose-albumin ratioBiomarkerPredicting
spellingShingle Wanyun Tang
Xiaomin Ni
Wei Yao
Wei Wang
Yuhao Li
Qiaomei Lv
Wenbo Ding
Renjian He
Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
Scientific Reports
Hip fracture
Pneumonia
Glucose-albumin ratio
Biomarker
Predicting
title Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
title_full Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
title_fullStr Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
title_full_unstemmed Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
title_short Glucose-albumin ratio (GAR) as a novel biomarker for predicting postoperative pneumonia (POP) in older adults with hip fractures
title_sort glucose albumin ratio gar as a novel biomarker for predicting postoperative pneumonia pop in older adults with hip fractures
topic Hip fracture
Pneumonia
Glucose-albumin ratio
Biomarker
Predicting
url https://doi.org/10.1038/s41598-024-60390-2
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