Abdülaziz DOĞAN, Ali ÜNAL
Eurasian Journal of Emergency Medicine - 2026;25(1):367-374
Aim: To compare the performance of hemoglobin, albumin, lymphocyte, and platelet (HALP), modified HALP (mHALP), and modified Rapid Emergency Medicine score (mREMS) in predicting 30-day mortality in geriatric patients presenting to the emergency department (ED) with hip fractures. Materials and Methods: This prospective, observational cohort study included 63 geriatric patients with hip fractures who presented to the ED. Demographic characteristics, vital signs, laboratory parameters, and clinical outcomes were recorded. The predictive performance of HALP, mHALP, and mREMS scores for mortality was evaluated using ROC analysis, and the area under the curve (AUC) were compared using the DeLong test. Results: The mean age of the patients was 78.59+/-6.81 years, and 63.5% were female. The 30-day mortality rate was 6.3% (n=4). In patients who died, heart rate and mREMS score were significantly higher, while oxygen saturation was significantly lower. ROC analysis showed that the mREMS score had apparent discriminative performance (AUC: 0.981; 95% confidence interval: 0.942-1.00; p<0.001); however, this estimate should be interpreted cautiously given the low number of mortality events (n=4). For mREMS, at a cut-off value of 7.5, sensitivity was 100% and specificity was 84.7%. HALP (AUC: 0.581; p=0.690) and mHALP (AUC: 0.513; p=0.942) scores showed no significant predictive value for mortality. The DeLong test results showed a statistically significant difference between mREMS and mHALP scores (p=0.009). Conclusion: The mREMS score showed apparent superiority over HALP and mHALP in predicting 30-day mortality; however, these findings should be considered exploratory and require confirmation in larger studies.
