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Olle Melander

Principal investigator

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Novel biomarkers for prediction of outcome in hip fracture patients—An exploratory study

Author

  • Magnus H. Jonsson
  • Ami Hommel
  • Lizbet Todorova
  • Olle Melander
  • Peter Bentzer

Summary, in English

Background: Little is known about the value of biomarkers for prognostication in hip fracture patients. The main objective of the present study was to assess if biomarkers add useful information to an existing risk score for prediction of 30-day mortality in patients suffering from out of hospital hip fractures. Methods: In a prospective observational single centre study, association between plasma concentration of ninety-two biomarkers at admission and 30-day mortality was analysed using logistic regression adjusted for risk factors included in Nottingham Hip Fracture Score (NHFS). Biomarkers associated with the outcome in the adjusted analysis were further evaluated by calculating the net reclassification improvement (NRI) and the change in area under the receiver operating characteristics curve (AUC) relative to the NHFS. Results: 997 patients were included. Sixty-two patients died within 30 days (6.2%). Eleven biomarkers were associated with 30-day mortality in adjusted analysis. Of these biomarkers Growth Differentiation Factor-15 (GDF-15) had NRI for the primary outcome (12.1%; 95% CI: 1.2-23.3) and Carbohydrate Antigen 125 (CA-125) improved the AUC relative to NHFS (improvement: 0.05; 95% CI: 0.01-0.10, P =.027). Both CA-125 and GDF-15 improved the AUC for a composite outcome of 30-day mortality and cardiovascular complications. Conclusions: Adding GDF-15 or CA-125 to the Nottingham Hip Fracture Score improves the discrimination with regard to predicting 30-day mortality and may help to identify a subgroup of hip fracture patients with a particularly poor prognosis. The value of these biomarkers should be explored in further studies to confirm clinical utility.

Department/s

  • Fluid resuscitation in critical illness
  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Department of Clinical Sciences, Lund
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Cardiovascular Research - Hypertension
  • Clinical Research in Anaesthesia and Intensive Care Medicine

Publishing year

2020-08

Language

English

Pages

920-927

Publication/Series

Acta Anaesthesiologica Scandinavica

Volume

64

Issue

7

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Orthopedics
  • Cardiac and Cardiovascular Systems

Keywords

  • biomarkers
  • CA-125
  • GDF-15
  • hip fractures
  • mortality
  • NHFS
  • prognostications

Status

Published

Research group

  • Fluid resuscitation in critical illness
  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Cardiovascular Research - Hypertension
  • Clinical Research in Anaesthesia and Intensive Care Medicine

ISBN/ISSN/Other

  • ISSN: 0001-5172