Nutritional and Inflammatory Markers and In-hospital Mortality in Geriatric Hip Fractures: A Retrospective Study
TL;DR
Structured nutritional screening may provide more clinically meaningful short-term risk stratification than isolated laboratory-derived indices in geriatric hip fracture patients.
Abstract
Background: Geriatric hip fractures are associated with high morbidity and mortality. Malnutrition and systemic inflammation are common in this population and may adversely affect outcomes. This study evaluated the associations of nutritional and inflammatory markers with in-hospital mortality. Methods: Geriatric patients admitted with hip fractures between January 2018 and January 2022 were retrospectively analyzed. Nutritional status was assessed using the Prognostic Nutritional Index, Nutritional Risk Screening (NRS-2002), and Geriatric Nutritional Risk Index. Inflammatory markers included the C-reactive protein/albumin ratio (CAR), neutrophil-to-lymphocyte ratio, and platelet-to-albumin ratio. The primary endpoint was all-cause in-hospital mortality during the index hospitalization. Results: Among 400 patients, the in-hospital mortality rate was 5.0% (n = 20), and 34.0% (n = 136) required intensive care unit admission. Non-survivors were significantly older, had lower body mass index, and higher NRS-2002 scores (all P < .050). In multivariable logistic regression models adjusted for age and sex, higher NRS-2002 scores remained independently associated with mortality (OR: 3.26-3.40; 95% CI: 1.51-7.18; all P ≤ .003), whereas CAR and PNI were not. Receiver operating characteristic curves analysis demonstrated the highest discriminatory ability for NRS-2002 (area under the curve: 0.685), followed by CAR (0.631) and PNI (0.568). Conclusion: Nutritional Risk Screening-2002 was the only marker consistently associated with in-hospital mortality. Structured nutritional screening may provide more clinically meaningful short-term risk stratification than isolated laboratory-derived indices in geriatric hip fracture patients. Cite this article as: Özaltaş B, Ar AY, Abitağaoğlu S, Demiroluk Ö, Yilmaz B. Nutritional and inflammatory markers and in-hospital mortality in geriatric hip fractures: a retrospective study. Eurasian J Med. 2026, 58(4), 1505, doi: 10.5152/eurasianjmed.2026.261505.