Nutrition-related clinical laboratory indicators in perioperative management of geriatric hip fractures: a narrative review from risk stratification to precision intervention
Abstract
Geriatric hip fracture represents a major global public health crisis that extends far beyond acute skeletal trauma, reflecting and accelerating systemic physiological decline in older adults. Malnutrition, affecting up to 46% of these patients depending on diagnostic criteria, has been established as a pivotal modifiable determinant of adverse postoperative outcomes including complications, functional decline, and mortality. Against this backdrop, nutrition-related clinical laboratory indicators have gained increasing recognition as objective, quantifiable, and readily accessible tools with potential dual utility in prognostic risk stratification and therapeutic monitoring, yet a comprehensive synthesis of their comparative performance and clinical translation remains lacking. This narrative review therefore aims to systematically synthesize current evidence on the spectrum of nutrition-related laboratory biomarkers ranging from classical protein markers (serum albumin and prealbumin), through inflammatory-nutritional composite indices (Prognostic Nutritional Index, Controlling Nutritional Status score, C-reactive protein/albumin ratio, glucose/albumin ratio, and systemic immune-inflammation index), to emerging proteomic and bone turnover biomarkers, and to critically appraise their predictive value for postoperative complications, functional recovery trajectories, and short- to long-term mortality. We further examine the pathophysiological nexus linking malnutrition,…
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