Medicinal, Psychological, and Health Research Journal (MPHRJ)

Predictive Value of the Systemic Immune-Inflammation Index for Acute Postoperative Complications in Elderly Patients Undergoing Femoral Fracture Surgery

Document Type : Original Article

Authors

Tala Pourlak 1
Parham Maroufi 2

1 Associate Professor of Pathology, Department of Pathology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 Associate Professor of Orthopaedics, Department of Orthopedics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

10.5281/zenodo.23168058
Abstract
Introduction: Geriatric femoral fractures frequently precipitate severe acute postoperative complications, yet early risk stratification remains suboptimal. Given the potential of systemic inflammatory markers to reflect perioperative stress, identifying reliable biomarkers is clinically critical. Therefore, this study aimed to evaluate the predictive value of the systemic immune-inflammation index for acute postoperative complications in elderly patients undergoing femoral fracture surgery.

Material and methods: This descriptive cross-sectional study at Shohada Hospital, Tabriz, enrolled 118 elderly patients with femoral fractures, determined by Cochran’s formula. Preoperative systemic immune-inflammation index (SII) values were calculated from complete blood counts. Participants were prospectively evaluated to assess the association between admission SII and acute postoperative complications, with statistical models utilized to determine the index’s prognostic accuracy in predicting adverse surgical outcomes.

Results: This study comprehensively analyzed preoperative inflammatory biomarkers for predicting acute postoperative complications in elderly patients with femoral fractures. Key findings indicate that elevated SII (AUC=0.865), NLR (AUC=0.782), and PLR (AUC=0.714) are significantly associated with increased complication risk. The multivariable model demonstrated superior predictive accuracy (AUC=0.912), highlighting the clinical utility of these indices for early risk stratification and tailored perioperative management.

Conclusion: Preoperative assessment of systemic inflammatory indices, particularly SII, offers valuable insights into the risk of acute postoperative complications in elderly hip fracture patients, enabling targeted interventions for improved outcomes.

Graphical Abstract

Predictive Value of the Systemic Immune-Inflammation Index for Acute Postoperative Complications in Elderly Patients Undergoing Femoral Fracture Surgery

Keywords

Systemic Immune-Inflammation Index
Neutrophil-to-Lymphocyte Ratio
Postoperative Complications
Elderly Patients
Risk Stratification
Subjects
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Medicinal, Psychological, and Health Research Journal (MPHRJ)
Volume 3, Issue 1
January and February 2027
Pages 113-122

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