Bone turnover biomarkers predict one-year all-cause mortality and walking ability in geriatric hip fracture patients

• Published in: Bone (New York, N.Y.) Vol. 177; p. 116922
• Main Authors: Wu, Rongjie, Ma, Yuanchen, Chen, Duanyong, Li, Mengyuan, Li, Zeng, Deng, Zhantao, Zheng, Qiujian, Fu, Guangtao
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.12.2023
• Subjects: Born turnover markers; Disability; Hip fracture; Mortality; Disability; Hip fracture; Mortality; Born turnover markers
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/j.bone.2023.116922

To investigate the utility of serum C-terminal cross-linking telopeptides (β-CTX) and procollagen type I N propeptide (PINP) for predicting one-year mortality and walking ability in Chinese geriatric hip fracture patients who underwent surgical interventions. Elderly patients (≥ 60 years) who underwent surgical interventions for unilateral low-energy hip fracture from 2015 to 2020 in our center were included. Demographic data was retrospectively retrieved from the electronic medical database. The PINP and β-CTX concentrations were measured before the surgery. The patients were divided into two groups according to the outcome of mortality and walking ability after hip surgery, respectively. β-CTX and PINP were divided into four grades based on quartiles [Quartile(Q)1–4] for further analysis. All the variables with p < 0.1 in univariable analysis were included in a multivariable model. In univariable analysis, the levels of serum β-CTX (p = 0.007) and PINP (p = 0.025) was associated with one-year mortality, while the association between levels of serum β-CTX (p = 0.072) or PINP (p = 0.055) with one-year disability was marginally significant. After adjustment for confounders, the relative risk [OR (95 % CI), Q4 v sQ1, p-value] of one-year mortality and one-year disability were 7.28 (2.08–29.78, p = 0.003) and 3.97 (1.44–11.69, p = 0.009) for β-CTX and 5.87 (1.70–23.80, p = 0.008) and 3.48 (1.30–9.93, p = 0.016) for PINP, respectively. The coefficient of determination, AUC and bias-corrected C-index of predictive models based on previously reported predictors were significantly improved after integrating β-CTX or PINP. Higher serum β-CTX and PINP are independently associated with an increased risk of one-year mortality and disability in patients with hip fractures. The application of BTMs improves the performance of currently available predictive models. •This retrospective study evaluated the association between bone turnover markers and the prognosis of hip fractures.•Bone turnover markers are independently associated with one-year mortality and disability in patients with hip fractures.•Bone turnover markers enhance the accuracy of currently available models in predicting prognosis of hip fracture patients.