Perioperative risk factors in patients with a femoral neck fracture – influence of 25-hydroxyvitamin D and C-reactive protein on postoperative medical complications and 1-year mortality

摘要

This study examined the association of 25-hydroxyvitamin D (25(OH)D) and C-reactive protein (CRP) with postoperative medical complications and one year mortality of elderly patients sustaining a low-energy cervical hip fracture scheduled for surgery. We hypothesized that vitamin D deficiency and CRP in these patients might be associated with an increased 1-year mortality. The prospective single-center cohort study included 209 patients with a low-energy medial femoral neck fracture; 164 women aged over 50?years and 45 men aged over 60?years. Referring to 1-year mortality and postoperative?medical complications multiple logistic regression analysis including 10 co-variables (age, sex, BMI, ASA, creatinine, CRP, leukocytes hemoglobin, 25(OH)D, vitamin D supplementation at follow-up) was performed. Vitamin D deficiency was prevalent in 87?% of all patients. In patients with severe ( 20?ng/ml 25(OH)D levels (p?=0.027). Patients with a mild (CRP 10–39.9?mg/l) or active inflammatory response (CRP?≥?40?mg/l) showed a higher one year mortality of 33?% and 40?% compared to 16?% in patients with no (CRP?