The Role of HbA1c, CRP/Albumin, and Neutrophil/Lymphocyte Ratio in Predicting Mortality in Geriatric Patients with Diabetic Foot Ulcers

Objectives: This study aimed to evaluate the association between laboratory-based metabolic, inflammatory, and nutritional markers and in-hospital mortality among patients aged 65 years and older with diabetic foot ulcers. Materials and Methods: The retrospective study included 110 patients who were followed up for diabetic foot ulcers. Demographic characteristics, comorbidities, Wagner stage, length of stay, and routine laboratory parameters were recorded. The association of HbA1c, leukocyte count, neutrophil/lymphocyte ratio (NLR), CRP/albumin ratio (CAR), red blood cell distribution width (RDW), urea, and albumin levels with in-hospital mortality was evaluated. Patients discharged and those who died were compared. Factors associated with mortality were examined using logistic regression analysis, while discriminant performance was investigated using ROC analysis. Results: The median age of the patients was 73 years, and 67.3% were male. The median length of hospital stay was 23 days, and the median Wagner stage was 4. In-hospital mortality occurred in 24 patients (21.8%). In the death group, WBC, RDW, urea, and HbA1c levels were higher, and albumin levels were lower. The median HbA1c value was 7.50 in the discharge group and 9.90 in the death group. In multivariate analyses, HbA1c maintained its independent association with in-hospital mortality. In ROC analysis, HbA1c showed high discriminant performance (AUC: 0.944; 95% CI: 0.898–0.978; p<0.001). At a cutoff value of 8.80%, the sensitivity was 100%, the specificity was 86.0%, and the negative predictive value was 100%. Although numerically higher in the NLR and CAR death groups, this was not statistically significant. Conclusion: HbA1c may be an independent, practical, and easily accessible risk marker associated with in-hospital mortality in geriatric diabetic foot patients.