Ömer Levent KARADAMAR, Ali Murat BAŞAK, Anıl ÖZGÜR, Ali AYDİLEK, Uğur YÜZÜGÜLDÜ, Enes KELEŞ, Mustafa KARA
Türk Geriatri Dergisi - 2026;29(1):56-66
Introduction: Geriatric hip fractures are associated with high morbidity and mortality. Identifying reliable preoperative biomarkers may help predict postoperative mortality and improve perioperative management. Materials and Method: This retrospective study included 913 patients aged 65 years and older who underwent surgery for hip fractures between January 2017 and January 2024. Demographic characteristics, comorbidities, fracture type, surgical and anesthesia methods, ASA score, and preoperative hemoglobin, albumin, and lymphocyte levels were recorded. Mortality status was evaluated, and the diagnostic performance of albumin and lymphocyte levels in predicting mortality was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean age of the patients was 79.6 +/- 9.7 years, and the postoperative mortality rate was 51.6%. Mortality was significantly associated with lower preoperative albumin and lymphocyte levels (p<0.001). A preoperative albumin level <3.5 g/dL demonstrated excellent predictive performance for mortality, with a sensitivity of 99.8% and specificity of 99.5% (AUC: 0.997). The predictive accuracy of lymphocyte count was lower (AUC: 0.622). Mortality rates were also significantly higher in patients with an ASA score >=4 and in those who received blood transfusions. Conclusions: Preoperative serum albumin is a highly accurate biomarker for predicting mortality in geriatric patients undergoing hip fracture surgery. Low albumin levels may reflect malnutrition and reduced physiological reserve, contributing to poorer postoperative outcomes. Routine assessment of albumin may facilitate early identification of high-risk patients and support individualized perioperative management strategies.
