Evaluation of fetuin-A as a predictor of outcome after surgery for osteoporotic fracture of the proximal femur

Background In the elderly, osteoporotic fractures of the femur are associated with high morbidity and mortality. At the time of hospitalization and during pre-operative care identification of patients at risk for poor outcome despite an otherwise good clinical condition is challenging. We hypothesiz...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2020-10, Vol.140 (10), p.1359-1366
Main Authors: Steffen, Claas Jasper, Herlyn, Philipp K. E., Cornelius, Norina, Mittlmeier, Thomas, Fischer, Dagmar-C.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
alpha-2-HS-Glycoprotein - analysis
Femoral Fractures - epidemiology
Femoral Fractures - mortality
Femoral Fractures - surgery
Hospitalization
Humans
Medicine
Medicine & Public Health
Middle Aged
Orthopaedic Surgery
Orthopedics
Osteoporotic Fractures - epidemiology
Osteoporotic Fractures - mortality
Osteoporotic Fractures - surgery
Treatment Outcome
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Summary:Background In the elderly, osteoporotic fractures of the femur are associated with high morbidity and mortality. At the time of hospitalization and during pre-operative care identification of patients at risk for poor outcome despite an otherwise good clinical condition is challenging. We hypothesized that the serum concentration of fetuin-A during post-operative recovery might serve as a biomarker. Methods During a 15 months period patients admitted to our hospital for treatment of a femur fracture were registered on a voluntary basis and irrespective of age, underlying diseases and therapy. For all patients enrolled in this registry, blood was sampled for additional laboratory analysis. Patients with osteoporotic fractures were invited for follow-up examination about 2 years later. At this time, the functional outcome and clinical performance together with the handgrip strength as a surrogate measure of overall strength were assessed and the occurrence of additional fractures was recorded. Results from these assessments and the absence or presence of subsequent fractures were combined as summary score of outcome (SSO) and overall physical performance (oPP), a score derived by principal component analysis and relying on normally distributed data, only. Results 39 of 96 eligible patients were deceased during the follow-up period, while 45 consented to participate in the study. Patients with a SSO ≥ 17 pts were younger and had higher fetuin-A serum concentrations (each p  
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-019-03329-x