Percentage change in hemoglobin is closely linked to the one-year mortality rate in elderly patients who have suffered hip fractures

Purpose: The objective of this study was to examine the relationship between the percentage change in hemoglobin (ΔHb) and 1-year mortality among patients who underwent hip fracture surgery. Percentage ΔHb was defined as: ([preoperative Hb - nadir Hb]/preoperative Hb) × 100. Methods: A total of 636 patients with hip (including femoral neck and intertrochanteric femur) fractures who were hospitalised at an orthopaedic centre in China from January 2016 to December 2020 were reviewed as study subjects. General data were collected from patients, who underwent internal fixation or artificial femoral head replacement, and patients were followed up in outpatient clinics and by telephone for 1 year after surgery. The clinical value of predicting patient death was analysed using subject work characteristics (ROC) curve analysis, and multifactorial cox regression analysis was used to explore the influencing factors of death in elderly hip fracture patients at 1 year postoperatively. Results: Over the course of the year following surgery, 108 patients (17.0%) passed away. The study found that a ΔHb value of 28.1% was the optimal cutoff for predicting mortality, with a sensitivity of 67.6% and specificity of 74.1%. Patients who had higher ΔHb levels had a significantly higher mortality rate (34.8% vs. 8.2%, p 0.001), and after adjusting for other factors, high ΔHb remained an independent predictor for one-year all-cause mortality (HR 4.12, 95% CI 2.66–6.39, p 0.001). Other independent risk factors for survival included advanced age, Charlson comorbidity index (CCI) >2, Blood transfusion, low albumin level, and longer length of stay. Additionally, the findings from subgroup analysis were generally in agreement with the main results across most stratified groups. Conclusions: The percentage change in hemoglobin levels was found to be independently linked to the risk of mortality within one year. These outcomes indicate that utilizing percentage ΔHb as a metric could aid in identifying patients who are at a heightened risk for 1-year mortality.