What question did this study set out to answer?

The study aims to assess and compare the effectiveness of preoperative nutritional scores in predicting mortality following hip fractures in older adults.

June 1, 2026Open Access

Comparison of the predictive value of CONUT, NLR, and PNI for 6-month and 1-year mortality in middle-aged and older adults with hip fractures: a retrospective study

Puntos clave

The study aims to assess and compare the effectiveness of preoperative nutritional scores in predicting mortality following hip fractures in older adults.
Retrospective cohort analysis of 198 adults aged ≥50 who had hip fracture surgery at Jinjiang Municipal Hospital from January 2020 to December 2021.
Preoperative laboratory data were collected to compute CONUT, NLR, and PNI scores.
Predictive efficacy was evaluated using ROC curves, and mortality was compared using Kaplan–Meier analysis.
30 patients (15.15%) died within 6 months and 40 patients (20.20%) within 12 months after surgery.
High CONUT score was independently linked to increased short-term mortality, with AUC = 0.620 for 6-month and AUC = 0.617 for 12-month mortality (p < 0.05 for both).
Patients with CONUT ≥3 exhibited higher mortality rates at 6 months (20.16%) and 12 months (25.58%) compared to those with scores <3.

Resumen

Objective This study aimed to compare the predictive value of three preoperative nutritional status scores—Controlling Nutritional Status (CONUT) score, Neutrophil-to-Lymphocyte Ratio (NLR), and Prognostic Nutritional Index (PNI)—for 6-month and 12-month mortality in middle-aged and older adults with hip fractures. Methods A retrospective cohort study was conducted on 198 middle-aged and older adults (≥50 years) who underwent surgical treatment for hip fractures at Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital Fujian) between January 2020 and December 2021. Preoperative laboratory data were used to calculate CONUT, NLR, and PNI scores. Receiver operating characteristic (ROC) curves were used to evaluate predictive efficacy, and Kaplan–Meier analysis was used to compare mortality across nutritional status subgroups. Results Thirty patients (15.15%) died within 6 months and 40 (20.20%) within 12 months. Multivariate analysis suggested high CONUT score was independently associated with short-term mortality. The CONUT score significantly predicted 6-month (AUC = 0.620, 95% CI: 0.531–0.710, p = 0.036) and 12-month mortality (AUC = 0.617, 95% CI: 0.531–0.702, p = 0.022), with an optimal cut-off of 2.5. Patients with CONUT ≥3 had higher 6-month (20.16% vs. 5.80%) and 12-month mortality (25.58% vs. 10.14%) than those with CONUT 3. Conclusion Among the three scores, the CONUT score was associated with better predictive performance for 6-month and 12-month mortality in middle-aged and older adults with hip fractures. Preoperative CONUT score assessment may help identify high-risk patients and support targeted nutritional interventions. NLR and PNI showed limited value in predicting short-term mortality in this population. Trial registration This study has been registered in national medical research registration and filing information system of China, www.medicalresearch.org.cn , Trail registration number: MR-35-24-034127. Registration date: 28 August 2024.

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