Correlation between admission hypoalbuminemia and postoperative urinary tract infections in elderly hip fracture patients

Abstract

Purpose: This study aimed to evaluate the correlation between hypoalbuminemia upon admission and the incidence of postoperative urinary tract infections (UTIs) in elderly patients with hip fractures. Methods: A retrospective analysis was performed on the medical records of elderly patients who underwent surgical treatment for hip fractures at a level I trauma center from 2013 to 2023. Serum albumin levels were measured upon admission, and hypoalbuminemia was defined as a total albumin level < 35 g/L. Multivariable logistic regression and propensity score matching analysis were utilized to control and reduce potential confounding factors, aiming to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CI) for UTIs to determine the strength of the association. Results: This observational cohort study included 1279 patients, among whom 298 (23.3%) developed UTIs. Patients with albumin levels < 35 g/L had significantly greater odds of developing UTIs compared to those with albumin levels ≥ 35 g/L (OR 1.86, 95% CI 1.28–2.70). Further analysis, dividing albumin levels into quartiles, demonstrated that patients in the Q2 group (38.0–40.9 g/L; OR 1.38, 95% CI 0.88–2.17), Q3 group (35.0–37.9 g/L; OR 1.69, 95% CI 1.06–2.71), and Q4 group (15.3–34.9 g/L; OR 2.67, 95% CI 1.61–4.43) had notably higher odds of developing UTIs compared to those in the Q1 group (41.0–52.0 g/L). Conclusions: The presence of hypoalbuminemia upon admission in elderly patients undergoing hip fracture surgery is strongly correlated with the occurrence of postoperative UTIs. Furthermore, this association exhibits a clear dose–response relationship.