Bidirectional Relationship Between Hypoalbuminemia and Postoperative Pneumonia in Elderly Hip Fracture Patients: A Retrospective Cohort Study
Abstract
Background Postoperative pneumonia is a common and severe complication following hip fracture (HF) surgery in the elderly. Hypoalbuminemia, a marker of poor nutritional status and systemic inflammation, is widely recognized as a predictor of adverse outcomes. However, their bidirectional relationship in elderly HF patients remains underexplored. Methods This retrospective cohort study was conducted in China enrolling elderly patients (≥65 years) with HFs between Mar 2020 and Feb 2023. After predefined participants selection inclusion and exclusion criteria, 1661 surgically treated HF patients were included and analyzed utilizing multiple statistical models, including univariate logistic regression, Lasso regression, and Boruta algorithm for variable selection, while multivariate logistic regression and propensity score matching (PSM) for assess the bidirectional relationship between hypoalbuminemia and postoperative pneumonia. All participants’ demographics, injury-related data, surgery-related data, perioperative complications, and two-year follow-up mortality rates were collected and compared. Results A total of 1,661 patients were included, of whom 144 developed postoperative pneumonia (8.67%). Preoperative hypoalbuminemia was identified as an independent risk factor for postoperative pneumonia (OR: 7.96, 95% CI: 4.08–15.53, P<0.001), while postoperative pneumonia itself was associated with an increased risk of developing hypoalbuminemia (OR: 2.34, 95% CI: 1.62–3.38,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,661 participants or records.
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