• Emine Dizem Sunal Altın, Nur Canbolat, Mehmet I Buget, Yekta Furkan Altın, Serkan Bayram, and Kemalettin Koltka.
• Department of Anesthesiology and Reanimation, Istanbul Faculty of Medicine, Istanbul University, Turgut Ozal Millet Cd, 34093, Istanbul, Turkey.
• J Anesth. 2024 Dec 15.

PurposeGiven the occurrence of comorbidities in geriatric patients, the postoperative period of hip fractures may progress with high morbidity and mortality. Recently, several inflammatory markers have been used to evaluate the treatment course. Herein, we prospectively followed-up and examined the relationship between preoperative fibrinogen/albumin ratio(FAR) and morbidity/mortality in elderly patients with hip fracture.MethodsPatients aged ≥ 85 years who underwent hip fracture surgery under unilateral spinal anesthesia were included in this prospective observational study. The patients' preoperative FAR, age-adjusted Charlson comorbidity index(AACCI) score, Nottingham Hip Fracture Score, and Clinical Frailty Scale score were calculated. In addition, data on patients' morbidity, 3-month mortality, and lengths of intensive care unit (ICU) and hospital stay were recorded. The patients were categorized into two groups based on the FAR cutoff value of 0.102. A total of 108 patients participated in the study, with 43 assigned to Group 1(FAR < 0.102) and 65 to Group 2(FAR ≥ 0.102).ResultsA significant difference was found in the risk of death within 3-months between patients with high and low FAR scores(p = 0.018). Patients with higher FAR scores were more likely to die within 3 months. A significantly positive association was observed between the FAR and AACCI score, with the AACCI score of Group2 being significantly higher than that of Group 1(p = 0.029). The lengths of hospital(p = 0.044) and ICU(p = 0.013) stay were significantly higher in Group2 than in Group1.ConclusionPreoperative FAR, which is an inexpensive and readily available test, is a promising index for predicting mortality and complications in patients with hip fracture.© 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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