There’s an article in today’s Wall Street Journal, Test May Reduce Death After Hip Fracture, that is firmly in the lay press’s tradition of misunderstanding medical science. Part of the reason in this instance is that there’s not much in the source paper they quote. And second is that the study the Journal discusses has nothing to do with reducing death after this type of fracture. Rather its a meta-analysis of markers that predict a bad outcome. There’s no intervention in this paper. (It hasn’t appeared online yet so I can’t link to it.)
According to the WSJ: Researchers in Denmark analyzed 15 studies from 1999 to 2011 that measured biochemical markers associated with increased risk of death in 8,553 patients admitted to hospital with hip fractures…The meta-analysis showed that patients with low hemoglobin, high creatinine, high parathyroid hormone levels, low albumin and low TLC (total lymphocyte count) were at greater risk of dying from hip-fracture complications than those with biomarkers in the normal range. Patients with low albumin combined with either high or low TLC also had an increased mortality risk.
I don’t doubt the accuracy of the above finding; it’s just that they contain nothing new. Reduced renal function (high creatinine) has been known for years to be a marker for increased mortality when it is superimposed on any acute illness. The same is true for albumin and anemia. In general all these markers indicate poor overall health. People in bad shape to begin with obviously don’t do as well as compared to people with the same acute problem who were in good condition before the acute event.
Broken hips are a major cause of morbidity and mortality in elderly patients. Patients at greatest risk for them, ie the elderly, patients with osteoporosis, and those with impaired mobility or balance should be as careful as possible to avoid circumstances where they are at increased risk of falling. A fall that would be hardly noticed by a young person may prove lethal in the old.
