ArticleFrontiers in nutrition2026
A retrospective analysis of the link between the prognostic nutritional index and 1-year mortality rates in older adults suffering from femoral neck fractures.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Femoral neck fractures are associated with high mortality rates in older adults, and nutritional status represents a potentially modifiable risk factor. The Prognostic Nutritional Index (PNI) serves as a simple, objective measure of nutritional and immune status; however, its capacity to predict 1-year mortality following femoral neck fractures surgery remains inadequately explored. Objective: This study aimed to: (1) examine the association between preoperative PNI and 1-year mortality after surgical treatment of femoral neck fractures in older adults, and (2) evaluate the predictive performance of PNI for postoperative survival. Methods: We conducted a retrospective cohort study at a tertiary academic medical center in China. Patients aged 60 years or older who underwent surgery for femoral neck fractures between January 2020 and January 2021 were included. Data on demographics, comorbidities, laboratory values (including serum albumin and lymphocyte count for PNI calculation), and 1-year mortality were extracted from electronic health records. Statistical analyses included multivariable logistic regression, restricted cubic spline (RCS) modeling, and receiver operating characteristic (ROC) curve analysis. Results: Among the 954 patients included in the analysis, 82 (8.6%) died within 1 year following surgery. Compared to survivors, patients in the mortality group had significantly lower preoperative prognostic nutritional index (PNI) scores (42.96 ± 4.64 vs. 45.92 ± 4.52, p < 0.001). In a multivariable-adjusted analysis accounting for age, sex, comorbidities, and type of surgery, a higher PNI remained independently associated with a reduced risk of 1-year mortality (OR = 0.94, 95% CI: 0.89-0.99, Conclusion: Preoperative PNI is an independent predictor of 1-year mortality in older adults with femoral neck fractures. This simple and accessible marker may be incorporated into routine preoperative assessments to facilitate early identification of patients at heightened risk, supporting targeted nutritional interventions in perioperative nursing care.
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