Predictive value of MON/HDL ratio on mortality at 1 and 6 months in patients over 65 years of age scheduled for hip fracture surgery

In this research, the aim was to evaluate the predictive value of the monocyte/high density lipoprotein (MON/HDL) ratio on mortality at 1 and 6 months in patients over 65 years of age scheduled for hip fracture surgery. A total of 129 patients aged 65 and older, who were surgically admitted due to hip fractures at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital Orthopedics and Traumatology Clinic between January 18, 2022, and July 31, 2022, were included in this study. Baseline characteristics, clinical parameters, blood ratios, and MON/HDL levels of patients were evaluated. Receiver operating characteristic analysis was used for the predictive values of MON/HDL for the 1st and 6th month. HDL (r = -0.200; P < .05), monocyte (r = 0.402; P < .01), C-reactive protein (CRP) (r = 0.253; P < .01), intensive care unit duration (r = 0.221; P < .05), MON/HDL (r = 0.423; P < .01), neutrophil/HDL (r = 0.182; P < .05), monocyte-to-lymphocyte ratio (r = 0.256; P < .01), and albumin/CRP (r = -0.239; P < .01) were significantly correlated with 1st month mortality. The area under the curve (AUC) was 0.906 for MON/HDL, and for the MON/HDL 0.0208 cutoff point, sensitivity was 92.3% and specificity was 87.1% in 1st month mortality. Sixth month mortality was significantly correlated with HDL (r = -0.248; P < .01), CRP (r = 0.193; P < .05), intensive care unit duration (r = 0.209; P < .05), red blood cell distribution width (r = 0.220; P < .05), operation duration (r = 0.227; P < .05), MON/HDL (r = 0.266; P < .01), neutrophil/HDL (r = 0.229; P < .05), albumin/CRP (r = -0.201; P < .05), and hemoglobin/red blood cell distribution width (r = -0.226; P < .05) parameters. AUC was 0.690 for MON/HDL, and for the MON/HDL 0.0127 cutoff point, sensitivity was 66.7% and specificity was 57.6% in the 6th month mortality results. The MON/HDL ratio may have predictive value for 1st and 6th month mortality for patients over 65 years of age scheduled for hip fracture surgery. The predictive value of the MON/HDL ratio for 6-month mortality (AUC 0.690) is only moderate, and its clinical utility may be limited, requiring validation with other indicators or larger cohorts.