Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study

• Published in: BMC geriatrics Vol. 21; no. 1; p. 155
• Main Authors: Wang, Zhi-Cong, Jiang, Wei, Chen, Xi, Yang, Ling, Wang, Hong, Liu, Yue-Hong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.03.2021; BioMed Central; BMC
• Subjects: Age; Aged; Blood platelets; Cardiovascular disease; Care and treatment; China; Cohort analysis; Comorbidity; Female; Fractures; Geriatrics; Hip; Hip fracture; Hip joint; Hospitals; Humans; Inflammation; Inflammation - diagnosis; Laboratories; Leukocytes (neutrophilic); Lymphocytes; Male; Medical prognosis; Mortality; Neutrophils; Older adults; Older people; Platelets; Practice guidelines (Medicine); Prognosis; Prospective Studies; Public health; Risk factors; Surgery; Systemic immune-inflammation index; China; Hip fracture; Prognosis; Older adults; Mortality; Systemic immune-inflammation index
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-021-02102-3

The systemic immune-inflammation index (SII), based on peripheral platelet, neutrophil and lymphocyte counts, has been proven to be a promising prognostic indicator in various diseases. Hip fracture is a common injury among the older adults, and has become a global public health problem with high mortality and disability rates. However, the relationship between SII and the prognosis of hip fracture is not yet well-known. The aim of the this study was to explore the predictive value of SII in older adults with hip fracture undergoing surgery. This was a prospective cohort study performed from January 2014 to December 2018 at a orthopaedic center, China. The SII was calculated as platelet×neutrophil/lymphocyte counts. Univariable and multivariable Cox proportional hazard models were used to assess the association between SII and all-cause mortality. A total of 290 older adults with hip fracture were included, and the mean (SD) age was 77.6 (8.6) years, and 189 (65.2%) were female. The median (IQR) SII was 759.4 (519.0-1128.7) × 10 /L. After a median follow-up time of 33.4 months, 13 (4.5%), 26 (9.0%) and 54 (18.6%) patients died within the 30-day, 1-year and last follow-up, respectively. Multivariable Cox analysis revealed that each increase of 100 units of SII was associated with a 8% increased hazard of death at 1-year follow-up (HR = 1.08, 95% CI: 1.01-1.17, p = 0.033), and 9% increased hazard of death at last follow-up (HR = 1.09, 95% CI: 1.03-1.15, p = 0.003). SII is associated with poor all-cause mortality in older adults with hip fracture undergoing surgery, and deserves further investigation and application in clinical practice.