Effects of Albumin/Globulin Ratio on Mortality in Geriatric Patients with Hip Fracture Presenting to the Emergency Department

Öz

Backgrounds: Albumin and globulin are known as markers of systemic inflammation. While low albumin levels are associated with both inflammation and poor nutritional status, globulin levels may increase during inflammation. The aim of this study is to determine the prognostic value of albumin/globulin ratio on mortality after hip fractures in geriatric patients. Methods: The data of patients aged between 65 and 111 with geriatric hip fractures who presented to the Emergency Department of Dicle University Medical Faculty Hospital between December 1, 2019, and December 31, 2021, were retrospectively analyzed. The study investigated clinical data of these patients, and the effects of the albumin/globulin ratio in biochemistry on mortality. Results: In our study, 140 participants were included, 81 of whom were female. The average age of the participants was 79.8 ± 8.7 years. Among the participants, 73.6% had at least one comorbidity. It was found that the ages of the patients in the dying group were significantly lower compared to those in the surviving group (p<0.05). Additionally, the proportion of male patients was significantly higher in the deceased group (p<0.05). There was no significant difference in comorbidity rates between the dying and surviving groups (p>0.05). A significant efficacy of the AGR (Albumin/Globulin Ratio) 1.12 cut-off value was observed in distinguishing between dying and surviving patients, with an area under the curve of 0.739 (0.610-0.868). The mortality rate among patients with an AGR greater than 1.12 was significantly lower (p < 0.05) compared to those with an AGR of 1.12 or less. Conclusion: In conclusion, a low albumin/globulin ratio (AGR) has been associated with high mortality in geriatric patients with hip fractures.

Anahtar Kelimeler

• Albumin
• Globulin
• Geriatric
• Hip fractures
• Mortality

Kaynakça

1. 1.Demir M, Özbek M, Aktan A, Ertaş F. Fibrinogen toAlbumin Ratio Predicts Burden of Coronary ArteryDisease in Patients with NSTEMI. Dicle Med J.2021;48(4):688-95.
2. 2.Bilgin B, Sendur MAN, Yücel Ş, Hizal M, Yalçın B.Prognostic Importance of Albumin Globulin Ratio inSmall Cell Lung Cancer. Ankara Med J. 2019;19(4):729-35.
3. 3.Agar A, Sahin A. Top 100 Cited Articles On GeriatricHip Fractures In Orthopaedics: A Bibliometric AndVisualised Analysis. Dicle Med J. 2022;49(1):102-10.doi: 10.5798/dicletip.1086274.
4. 4.Mert M, Ermutlu C. Evaluation of Vitamin D andBiochemical Parameters in Patients Operated For HipFracture. Dicle Med J. 2020;47(2):446-54.
5. 5.Gupta D, Lis CG. Pretreatment serum albumin as apredictor of cancer survival: a systematic review of theepidemiological literature. Nutr J. 2010;9:69.
6. 6.Yildirim M, Yildiz M, Duman E, Goktas S, Kaya V.Prognostic importance of the nutritional status andsystemic inflammatory response in non-small cell lungcancer. J BUON. 2013;18(3):728-32.
7. 7.Li X, Qin S, Sun X, et al. Prognostic Significance ofAlbumin-Globulin Score in Patients with OperableNon-Small-Cell Lung Cancer. Ann Surg Oncol.2018;25(12):3647-59.
8. 8.Lv GY, An L, Sun XD, Hu YL, Sun DW. Pretreatmentalbumin to globulin ratio can serve as a prognosticmarker in human cancers: a meta-analysis. Clin ChimActa. 2018;476:81-91.

9. 9.Bergström U, Björnstig U, Stenlund H, Jonsson H,Svensson O. Fracture mechanisms and fracture patternin men and women aged 50 years and older: a study ofa 12-year population-based register, Umea, Sweden.Osteoporos Int. 2008;19:1267-73.
10. 10.Haentjens P, Magaziner J, Colon-Emeric CS, et al.Meta-analysis: excess mortality after hip fractureamong older women and men. Ann Intern Med.2010;152:380-90.
11. 11. Jiang HX, Majumdar SR, Dick DA, et al. Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patients with hipfractures. J Bone Miner Res. 2005;20:494-500.
12. 12.Clague JE, Craddock E, Andrew G, Horan MA,Pendleton N. Predictors of outcome following hipfracture. Admission time predicts length of stay and in-hospital mortality. Injury. 2002;33:1-6.
13. 13.Kanis JA, Oden A, Johnell O, et al. The componentsof excess mortality after hip fracture. Bone.2003;32:468-73.
14. 14.Çiftçi AB, Yemez K, Eraslan H.Pankreatikoduodenektomi hastalarındaalbümin/globulin oranının ameliyat sonrası pankreasfistülünü öngörmedeki rolü. TJCL. 2022;13(3):408-15.
15. 15.Aydın A, Kaçmaz O, Öterkuş M, Miniksar ÖH. MPV,RDW, LAKTAT, NA ve Albumin Düzeyleriyle YoğunBakım Hasta Mortalitesi Arasındaki İlişki. Dicle Med J.2022;49(1):168-75.