Prognostic Value of CCI and HALP Score in Geriatric Femur Fractures: One-Year Emergency Department Experience

Öz

Objective: The objective of this study was to assess and contrast the predictive accuracy of the Charlson Comorbidity Index (CCI) and HALP (Hemoglobin-Albumin-Lymphocyte-Platelet) score in predicting short-term (30-day) and long-term (1-year) mortality in elderly individuals presenting to the emergency department with proximal femur fractures. Methods: This retrospective cohort study comprised 122 patients aged 65 years and older who had radiologically verified femoral neck or intertrochanteric fractures, who underwent surgical treatment between January 2023 and December 2023. Data regarding demographics, clinical features, and laboratory results were retrieved from electronic medical systems. The primary outcomes were short-term (30-day) and long-term (1-year) mortality. Statistical analyses were performed to assess associations between mortality and CCI, HALP, and other clinical variables. Results: The mortality rates of 30 day and 1-year were 9.8% and 29.5%. One-year mortality showed a strong correlation with increased age (p<0.001) and lower serum albumin levels (p=0.030). The HALP score was lower in deceased patients, however, this difference did not reach statistical significance (p=0.244). No significant association was observed between CCI and mortality at either 30-days or 1-year. ICU admission and prolonged hospital stay were strongly correlated with elevated 30-day mortality rates (p<0.001 and p=0.003, respectively). Conclusion: Advanced age and hypoalbuminemia were independently associated with increased 1-year mortality. While HALP and CCI scores showed numerical differences between survivors and non-survivors, only albumin reached statistical significance. ICU admission and extended hospitalization were significant predictors of short-term mortality. These findings highlight the need for multidimensional assessment tools combining clinical, nutritional, and inflammatory parameters to improve outcome prediction in elderly femur fracture patients.

Anahtar Kelimeler

• Geriatrics
• HALP score
• CCI
• Mortality

Geriatrik Femur Kırıklarında CCI ve HALP Skorunun Prognostik Değeri: Bir Yıllık Acil Servis Tecrübesi

Öz

Amaç: Bu çalışmada, acil servise proksimal femur kırığı ile başvuran geriyatrik hastalarda Charlson Komorbidite İndeksi (CCI)ve HALP (Hemoglobin, Albümin, Lenfosit, Trombosit) skorunun 30 günlük ve 1 yıllık mortaliteyi öngörmedekiprognostik değerinin değerlendirilmesi amaçlandı. Yöntemler: Retrospektif kohort tasarımla yürütülen bu çalışmaya, Ocak 2023–Aralık 2023 tarihleri arasında cerrahi tedavi uygulanmış, radyolojik olarak doğrulanmış femur boyun veya intertrokanterik kırığı olan 65 yaş üstü 122 hasta dâhil edildi. Demografik, klinik ve laboratuvar verileri elektronik kayıt sisteminden elde edildi. Birincil sonuçlar 30 günlük ve 1 yıllık mortaliteydi. CCI, HALP ve diğer klinik değişkenlerle mortalite arasındaki ilişkiler analiz edildi. Bulgular: 30 günlük mortalite %9.8, 1 yıllık mortalite %29.5 olarak saptandı. 1 yıllık mortalite; ileri yaş (p<0.001) ve düşük serum albümin düzeyleriyle (p=0.030) anlamlı şekilde ilişkiliydi. Ölen hastalarda HALP skoru daha düşük bulunmasına rağmen, bu fark istatistiksel olarak anlamlı değildi(p=0,244). CCI skoru ile mortalite arasında anlamlı bir ilişki gözlenmedi. Yoğun bakım ihtiyacı ve uzun hastanede kalış süresi 30 günlük mortalite ile anlamlı ilişki gösterdi (sırasıyla p<0.001 ve p=0.003). Sonuç: İleri yaş ve hipoalbüminemi, 1 yıllık mortalite açısından bağımsız risk faktörleri olarak saptandı. HALP ve CCI skorları sayısal farklılık gösterse de yalnızca albümin düzeyi anlamlıydı. Yoğun bakım gereksinimi ve uzamış hastane yatışı erken dönem mortalite ile ilişkilendirildi. Bu bulgular, geriyatrik femur kırığı hastalarında prognozun daha doğru belirlenmesi için klinik, beslenme ve inflamasyon parametrelerini birleştiren çok boyutlu değerlendirme araçlarına ihtiyaç olduğunu göstermektedir.

Anahtar Kelimeler

• Geriatri
• HALP skoru
• CCI
• Mortalite.

Kaynakça

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