Clin Lab. 2026 Apr 1;72(4). doi: 10.7754/Clin.Lab.2025.250616.
ABSTRACT
BACKGROUND: Intertrochanteric fracture (ITF) is a common but devastating condition with high mortality in the elderly population. Early identification of high-risk patients to prevent poor prognosis is essential as treatment of postoperative adverse outcomes is complex. C-reactive protein (CRP)/albumin (ALB) ratio (CAR) is a predictor of prognosis in many diseases, but its correlation with postoperative prognosis in patients with ITF remains unclear.
METHODS: One hundred and six elderly patients who underwent ITF surgery between May 2021 and May 2023 were retrospectively analyzed. Patients were evaluated based on postoperative Harris Score and SF-36 Score for good and poor recovery groups. CAR, ALB, and hemoglobin with statistically significant differences in univariate analysis were included in multifactorial logistic regression analysis to screen for independent influences. Predictive efficacy was analyzed using the ROC curve to obtain the area under the curve (AUC). Sample regression models were constructed to test whether there was a nonlinear relationship between ALB and CAR and the prognostic outcomes of patients with ITF. The correlation of ALB and CAR with Harris Score and SF-36 Score was analyzed by Pearson’s correlation analysis.
RESULTS: Elevated CAR (OR = 2.18, p = 0.00) was an independent risk factor for poor recovery in patients with ITF, while ALB (OR = 0.90, p = 0.03) was an independent protective factor against poor recovery. All CAR showed good predictive efficacy when the cutoff value took CAR > 1.79. In contrast, the predictive efficacy of ALB was low. Restricted cubic spline model and Pearson’s correlation analysis showed a linear relationship between CAR, poor recovery in ITF patients, and a negative correlation with Harris Score and SF-36 Score.
CONCLUSIONS: Serum CAR is significantly associated with poor postoperative prognosis in elderly patients with ITF and may be an independent risk factor for postoperative quality of life and hip recovery.
PMID:41979637 | DOI:10.7754/Clin.Lab.2025.250616
