Predictive value of prognostic nutritional index for early postoperative mobility in elderly patients with pertrochanteric fracture treated with intramedullary nail osteosynthesis

Faust, Leon; Lerchenberger, Maximilian; Gleich, Johannes; Linhart, Christoph; Keppler, Alexander Martin; Suero, Eduardo; Schmidmaier, Ralf; Böcker, Wolfgang; Neuerburg, Carl; Zhang, Yunjie (2023): Predictive value of prognostic nutritional index for early postoperative mobility in elderly patients with pertrochanteric fracture treated with intramedullary nail osteosynthesis. Journal of Clinical Medicine. ISSN 2077-0383

Abstract

Background: Early postoperative mobilization is essential for orthogeriatric patients. The prog-nostic nutritional index (PNI) is widely used to evaluate nutritional status. This study sought to investigate the predictive value of PNI for early postoperative mobility in patients with pertro-chanteric femur fractures. Materials and methods: This study included 156 geriatric patients with pertrochanteric femur fractures treated with TFN-Advance (DePuy Synthes, Raynham, USA). Mobility was evaluated on the third postoperative day and by discharge. Stepwise logistic regression analyses were performed to evaluate the association significance of PNI with postop-erative mobility together with comorbidities. The optimal PNI cut-off value for mobility was ana-lyzed using the receiver operating characteristic (ROC) curve. Results: Three-day postoperatively, PNI was an independent predictor of mobility (OR: 1.14, 95% CI: 1.07-1.23, p < 0.01). By dis-charge, it was found that PNI (OR: 1.18, 95% CI: 1.08-1.30, p < 0.01) and dementia (OR: 0.17, 95% CI: 0.07-0.40, p < 0.001) were significant predictors. PNI correlated weakly with age (r = -0.27, p < 0.001). The PNI cut-off value for mobility on the third postoperative day was 38.1 (specifici-ty=78.5%, sensitivity=63.6%). Conclusion: Our findings indicate that PNI is an independent pre-dictor of early postoperative mobility in geriatric patients with pertrochanteric femur fractures treated with TFNA.

• Doc-Type: Article (LMU Hospital)
• Organisational unit (Faculties): 07 Medicine > Medical Center of the University of Munich > MUM - Musculoskeletal University Center Munich
• DFG subject classification of scientific disciplines: Life sciences
• DFG: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 491502892