CYTOKINE DYNAMICS AND LONG-TERM OUTCOMES IN GERIATRIC HIP FRACTURE PATIENTS
Journal
Academic Medical Journal
Date Issued
2025-07-18
Author(s)
Hajradinovikj, Dino
University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre - Skopje, Republic of North Macedonia
Arsovski, Oliver
Bogdanovski, Nenad
University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre - Skopje, Republic of North Macedonia
DOI
10.53582/AMJ255232s
Abstract
Introduction: Hip fractures in the elderly are associated with high morbidity, mortality, and reduced quality of life. This study investigated the role of systemic inflammation, measured through serum levels of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), in predicting outcomes following operatively treated hip fractures in patients over 65 years of age.
Materials and Methods: A prospective, nonrandomized study was conducted involving 40 patients with hip fractures classified as 31A or 31B (AO classification). Blood samples were collected at four time points: within 10 hours post-injury, 48–60 hours post-surgery, on the seventh postoperative day, and on the 30th postoperative day. Serum levels of CRP and TNF-α were measured using ELISA. Functional outcomes, including quality of life (SF-12), mobility, and pain, were assessed at 12 months post-injury.
Results: Elevated serum levels of CRP and TNF-α were significantly associated with reduced quality of life, mobility, and survival. Deceased patients exhibited significantly higher cytokine levels compared to survivors at all time points. Multivariate regression analysis identified CRP (p<0.0001) and TNF-α (p=0.017) as independent predictors of quality of life, while TNF-α was significantly associated with mobility (p=0.043).
Conclusion: CRP and TNF-α may serve as valuable biomarkers for identifying high-risk patients and guiding postoperative care. Monitoring inflammatory markers could improve outcomes in geriatric hip fracture patients by enabling targeted interventions and rehabilitation programs.
Materials and Methods: A prospective, nonrandomized study was conducted involving 40 patients with hip fractures classified as 31A or 31B (AO classification). Blood samples were collected at four time points: within 10 hours post-injury, 48–60 hours post-surgery, on the seventh postoperative day, and on the 30th postoperative day. Serum levels of CRP and TNF-α were measured using ELISA. Functional outcomes, including quality of life (SF-12), mobility, and pain, were assessed at 12 months post-injury.
Results: Elevated serum levels of CRP and TNF-α were significantly associated with reduced quality of life, mobility, and survival. Deceased patients exhibited significantly higher cytokine levels compared to survivors at all time points. Multivariate regression analysis identified CRP (p<0.0001) and TNF-α (p=0.017) as independent predictors of quality of life, while TNF-α was significantly associated with mobility (p=0.043).
Conclusion: CRP and TNF-α may serve as valuable biomarkers for identifying high-risk patients and guiding postoperative care. Monitoring inflammatory markers could improve outcomes in geriatric hip fracture patients by enabling targeted interventions and rehabilitation programs.
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