入院时血红蛋白、白蛋白水平对股骨粗隆间骨折患者预后的预测价值

Predictive values of hemoglobin and albumin levels on admission in the prognosis of intertrochanteric fractures

目的探讨入院时血红蛋白(HGB)、白蛋白(ALB)水平对股骨粗隆间骨折(ITF)患者术后预后的预测价值。方法回顾性收集北京京煤集团总医院骨科2019年5月至2022年5月收治的接受手术治疗的92例ITF患者进行研究,依据ITF患者术后6个月返院复诊时髋关节功能Harris评分将患者分为预后良好组(n=72)和预后不良组(n=18)。比较2组基线资料及HGB、ALB等实验室指标,通过受试者工作曲线(ROC)探讨入院时HGB、ALB对ITF患者术后预后的预测价值。结果预后不良组年龄、术后并发症个数显著大于预后良好组,ALB、HGB水平显著低于预后良好组,差异有统计学意义(P<0.05)。经Pearson相关性分析显示,ALB、HGB、年龄、术后并发症个数与ITF患者术后髋关节功能Harris评分间有关(P<0.05)。绘制ROC曲线显示,ALB、HGB单独、二者联合及所有指标总联合预测ITF患者术后预后的曲线下面积(AUC)值分别为0.810、0.855、0.924、0.958,其中总联合预测与ALB、HGB联合预测的AUC值比较,差异无统计学意义(Z=0.908,P=0.364)。结论入院时HGB、ALB可较好预测ITF患者术后预后情况,两者值越低,ITF患者术后预后不良发生可能性越大。

Objective To explore the predictive value of hemoglobin(HGB)and albumin(ALB)levels on admission in postoperative prognosis of intertrochanteric fractures(ITF).Methods A retrospective study was conducted on 92 ITF patients who underwent surgical treatment in the Department of Orthopedics of Beijing Jingmei Group General Hospital from May 2019 to May 2022.Based on the Harris Hip Score at 6 months afteRsurgery,the patients were divided into the good prognosis group(n=72)and pooRprognosis group(n=18).The baseline data and laboratory indicators like HGB and ALB were compared between the two groups.The predictive value of HGB and ALB on admission in the prognosis of ITF was explored by plotting the receiveRoperating characteristic(ROC)curve.Results Patients in the pooRprognosis group had significantly oldeRage,largeRcases of postoperative complications,and loweRALB and HGB on admission than those of good prognosis group(P<0.05).Pearson correlation analysis showed that ALB,HGB,age and cases of postoperative complications were significantly correlated with the postoperative HHS in ITF patients(P<0.05).The receiveRoperating characteristic(ROC)curve showed that the area undeRthe curve(AUC)of ALB,HGB,ALB+HGB and a combination of all indicators in predicting the postoperative prognosis of ITF was 0.810,0.855,0.924,and 0.958,respectively.AUC was high in ALB+HGB and a combination of all indicators,which was comparable without a significant difference(Z=0.908,P=0.364).Conclusion HGB and ALB on admission can betteRpredict the postoperative prognosis of ITF.The loweRthe values of both,the greateRthe likelihood of pooRpostoperative prognosis in ITF patients.