ALBUMIN AS AN INDEPENDENT MARKER OF MORTALITY IN PERIPROSTHETIC FEMORAL FRACTURES: A SINGLE-CENTRE RETROSPECTIVE COHORT STUDY

Peri-prosthetic femoral fractures (PPFF) are an important complication to consider following a total hip arthroplasty (THA) or total knee arthroplasty (TKA), PPFF are an increasing challenge to modern orthopaedic practice with incidence increasing nearly two-fold since 2013 and expectations to see year on year increase in incidence. PPFF are associated with a high 1-year mortality rate and implicates a significant financial burden to health systems. The aim of this study of this study was to investigate if basic serum investigations and patient characteristics are associated with 1- and 2-year mortality. A consecutive 67 admitted to a single centre district general hospital, Glangwili General Hospital, Carmarthen sustaining PPFF (THA, TKA and Interprosthetic) were identified and retrospectively reviewed. Patient information including Age, Gender, American Society of Anaesthesiologist (ASA) grade, Cognitive function (AMT-10), Baseline Mobility and admission serological investigations were recorded. Mortality rates respectively for 30 day, 1-year and 2-year were 4.4%, 10.3% and 16.2%. Increased Age, Higher ASA, Lower baseline AMT-10 and Low Albumin were identified as statistically significant predictors for mortality at both 1-year and 2-year on univariate analysis. Both lower Albumin levels (Adjusted OR 0.71 95%CI 0.55–0.92 P=0.0083) and lower AMT-10 (Adjusted OR 0.67 95% CI 0.49–0.90 p=0.0075) remain as independent predictors of mortality at 1-year and 2-year follow up on multivariate analysis. We suggest that admission serum Albumin and admission AMT-10 assessment can be utilised as independent predictors of mortality in those sustaining PPFF at both 1-year and 2-years.