Abstract
This study investigated the relationship between different components of the full
blood count, such as haemoglobin (Hb), total white cell count, total lymphocyte count
on admission and total neutrophil count as possible surrogate markers of conditions
that lead to increased mortality in hip-fracture patients. A total of 791 patients
were studied with 81.2% being females. The 1-year mortality was 26.4% (32.9% in males
compared with 24.9% in females). A significant increase in mortality was seen in anaemic
patients, especially with Hb 80–100 g l−1 (1-year mortality was 49.2%, p-value < 0.001) and patients with lymphocyte count ≤1.1 × 109 l−1 (33.2% mortality, p-value < 0.0001). There was no relationship between total white cell count or neutrophil count
and mortality. This information clearly suggests that Hb and total lymphocyte counts
may be surrogate markers for increased mortality after a hip fracture and can be used
for audit purposes to adjust for different case mixes between groups.
Keywords
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References
- Relative lymphocyte count: a prognostic indicator of mortality in elderly patients with congestive heart failure.Am Heart J. 2001; 142: 167-173
- Hip fractures in the elderly: predictors of one year mortality.J Orthop Trauma. 1997; 11: 162-165
- Effect of general anaesthesia and surgery on neutrophil phagocytic function.Anaesthesia. 2007; 50: 769-775
- Absolute peripheral blood lymphocyte count and subsequent mortality of elderly men. The Baltimore longitudinal study of aging.J Am Geriatr Soc. 1986; 34: 649-654
- Mortality associated with delay in operation after hip fracture: observational study.BMJ. 2006; 332: 947-951
- Associations between white blood cell count and risk for cerebrovascular disease mortality: NHANES II Mortality Study, 1976–1992.Ann Epidemiol. 2004; 14: 425-430
- Perioperative blood transfusion and postoperative mortality.JAMA. 1998; 279: 199-205
- Total lymphocyte count: a promising prognostic index of mortality in patients on CAPD.Perit Dial Int. 2000; 20: 33-38
- Value of lymphocyte counts as a prognostic index of survival following femoral neck fractures.Injury. 1989; 20: 352-354
- Femur bone mineral density is independently associated with functional recovery after hip fracture in elderly women.Arch Phys Med Rehabil. 2002; 83: 1715-1720
- WBC count and the risk of cancer mortality in a national sample of U.S. adults: results from the Second National Health and Nutrition Examination Survey mortality study.Cancer Epidemiol Biomarkers Prev. 2004; 13: 1052-1056
- Reliability of the total lymphocyte count as a parameter of nutrition.Can J Surg. 1985; 28: 216-219
- A prospective assessment of nutritional status and complications in patients with fractures of the hip.J Orthop Trauma. 1990; 4: 49-57
- Prevalence of anaemia in older persons: systematic review.BMC Geriatr. 2008; 8
- Mortality after admission to hospital with fractured neck of femur: database study.BMJ. 2002; 325: 868-869
- Proximal femoral fractures: some determinants of outcome.J Epidemiol Community Health. 1988; 42: 365-369
- The relationship between admission haemoglobin level and outcome after hip fracture.J Orthop Trauma. 2002; 16: 39-44
- The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture.J Orthop Trauma. 2004; 18: 369-374
- Lymphocyte count and mortality risk in older persons. The Leiden 85-Plus Study.J Am Geriatr Soc. 2003; 51: 1461-1465
- The definition of anemia in older persons.JAMA. 1999; 281: 1714-1717
- Mortality and morbidity after hip fractures.BMJ. 1993; 307: 1248-1250
- The effects of nutritional status on outcome after hip fracture.J Orthop Trauma. 1999; 13: 164-169
- A low lymphocyte percentage is a predictor of mortality and hospitalization in hemodialysis patients.Clin Nephrol. 2005; 63: 22-34
- Anemia status, hemoglobin concentration, and mortality in nursing home older residents.J Am Med Dir Assoc. 2007; 8: 322-327
- Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women's Health Initiative Observational Study.Arch Int Med. 2005; 165: 500-508
- Early mortality after hip fracture: is delay before surgery important?.J Bone Joint Surg (Am). 2005; 87-A: 483-489
- Decline of blood haemoglobin in the aged: a longitudinal study of an urban Swedish population from age 70 to 81.Br J Haematol. 1989; 71: 437-442
- Protein depletion and metabolic stress in elderly patients who have a fracture of the hip.J Bone Joint Surg (Am). 1992; 74-A: 251-260
- Anemia in old age is associated with increased mortality and hospitalization.J Gerontol A Biol Sci Med Sci. 2006; 61: 474-479
- The effects of surgical trauma on human granulopoiesis.Br J Haematol. 1980; 44: 263-268
- Mortality risk in hemodialysis patients and changes in nutritional indicators: DOPPS.Kidney Int. 2002; 62: 2238-2245
- The use of two nutritional indicators in identifying long bone fracture patients who do and do not develop infections.J Orthop Res. 1990; 8: 799-803
- White blood cells as a novel mortality predictor in haemodialysis patients.Nephrol Dial Transplant. 2003; 18: 1167-1173
- Time trends and demography of mortality after fractured neck of femur in an English population, 1968–98: database study.BMJ. 2003; 327: 771-775
- Effects of co-morbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study.BMJ. 2005; 331: 1374
- The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure.Am J Emerg Med. 2006; 24: 451-454
- White cell count and cardiovascular mortality: white blood cell count and mortality in the Baltimore Longitudinal Study of Aging.J Am Coll Cardiol. 2007; 49: 1841-1850
- Assessment of malnutrition in hip fracture patients: effects on surgical delay, hospital stay and mortality.Acta Orthop Belg. 2006; 72: 420-427
- Relation of FEV1 and peripheral blood leukocyte count to total mortality: The Normative Aging Study.Am J Epidemiol. 1995; 142: 493-498
- A Prospective study of anaemia status. Haemoglobin concentration, and mortality in an elderly cohort: the cardiovascular health study.Arch Intern Med. 2005; 165: 2214-2220
Article info
Publication history
Accepted:
July 28,
2010
Identification
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© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
