The Prognostic Value of Inflammation Indices in Predicting Postoperative ICU Admission and Mortality in Elderly Patients Undergoing Hip Fracture Surgery

Objective: This study aimed to assess the predictive impact of various inflammation indices and inflammatory biomarkers on postoperative intensive care unit (ICU) admission and mortality following hip fracture (HF) surgery in elderly patients. Materials and Methods: We retrospectively reviewed the data of 131 geriatric patients who underwent isolated HF surgery under regional anesthesia. The patients were divided into two groups: ICU admission (ICU, n=98) and non-ICU admission (non-ICU, n=33). The patients were also grouped as survival (n=122) and non-survival (n=9) according to postoperative mortality rates. The patients' clinical characteristics and inflammation indexes were compared between the two groups, and predictors of ICU admission were determined using a multivariate regression model. Results: Advanced age and high American Society of Anesthesiologists (ASA) scores were observed in the ICU and Non-survivor groups. Urea and creatinine levels were significantly higher in the Non-survivor group. While inflammatory indices [systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio] were significantly higher in the ICU group (respectively, p=0.009, p=0.022, p=0.019), they did not differ significantly in the mortality group. Age, ASA score, and SII of the inflammation indices were determined to be independent predictors of postoperative ICU admission after HF surgery. Conclusion: It was shown that advanced age, high ASA score, and high preoperative SII value were independent risk factors for postoperative ICU admission following HF surgery in elderly patients. SII can be used as an easily measured prognostic parameter on the ICU admission of these surgical patients in daily practice.