Key result
A preoperative modified lymphocyte C-reactive protein score (mLCS) > 1 was independently associated with a significantly increased risk of 3-year mortality (HR 5.415) compared to a score ≤ 1.
Why the study?
Hip fractures are common in elderly patients who almost all undergo surgery, motivating the development of a novel score to predict 3-year mortality simply and conveniently.
Does the modified lymphocyte C-reactive protein score (mLCS) predict 3-year mortality in elderly patients undergoing intertrochanteric fracture surgery?
Cohort (n=291)
No
Does the modified lymphocyte C-reactive protein score (mLCS) predict 3-year mortality in elderly patients undergoing intertrochanteric fracture surgery?
The modified lymphocyte C-reactive protein score (mLCS) is a simple and effective prognostic indicator for predicting 3-year mortality in elderly patients after intertrochanteric fracture surgery.
This is the authors' abstract. We don't add key points for this paper.
BACKGROUND: Hip fractures are common in elderly patients, and almost all the patients undergo surgery. This study aimed to develop a novel modified lymphocyte C-reactive protein (CRP) score (mLCS) to simply and conveniently predict 3-year mortality in elderly patients undergoing intertrochanteric fracture surgery. METHODS: A retrospective study was conducted on elderly patients who underwent intertrochanteric fracture surgery between January 2014 and December 2017. The mLCS was developed according to the value of CRP and lymphocyte counts. Univariate and multivariate Cox regression analyses were used to identify independent risk factors for 3-year mortality after surgery. The performances of the lymphocyte CRP score (LCS) and mLCS to predict 3-year mortality were then compared using C-statistics, decision curve analysis (DCA), net reclassification index (NRI) and integrated discrimination improvement (IDI). RESULTS: A total of 291 patients were enrolled, of whom 52 (17.9%) died within 3 years after surgery. In the multivariate Cox regression analysis, mLCS (hazard ratio (HR), 5.415; 95% confidence interval (CI), 1.743-16.822; P = 0.003) was significantly associated with postoperative 3-year mortality. The C-statistics of LCS and mLCS for predicting 3-year mortality were 0.644 and 0.686, respectively. The NRI (mLCS vs. LCS, 0.018) and IDI (mLCS vs. LCS, 0.017) indicated that the mLCS performed better than the LCS. DCA also showed that mLCS had a higher clinical net benefit. CONCLUSIONS: mLCS is a promising predictor that can simply and conveniently predict 3-year mortality in elderly patients undergoing intertrochanteric fracture surgery.
Answers are grounded in this paper and cite their sources.
mLCS >1 may flag higher 3-year mortality risk after elderly intertrochanteric fracture surgery; leaves open utility pending prospective validation.
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He et al. (2023) conducted a cohort in Intertrochanteric fractures (n=291). Modified lymphocyte C-reactive protein score (mLCS) > 1 vs. mLCS ≤ 1 was evaluated on 3-year mortality (HR 5.415, 95% CI 1.743-16.822, p=0.003). A preoperative modified lymphocyte C-reactive protein score (mLCS) > 1 was independently associated with a significantly increased risk of 3-year mortality (HR 5.415) compared to a score ≤ 1.
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