| Objective To analyze the risk prediction and the influencing factors with prognostic nutritional index (PNI) after hip replacement in elderly patients with osteoporosis, and to discuss the effect of PNI on the outcome of hip replacement in elderly patients with osteoporosis. Methods The clinical data of 264 elderly patients with OP undergone hip arthroplasty from May 2016 to December 2018 were analyzed retrospectively. According to PNI index, there were 112 patients with PNI≥45 and 152 patients with PNI<45. Single factor and multivariate analysis were used to evaluate the current status and influencing factors of the outcome after hip arthroplasty in elderly patients with osteoporosis, and to analyze its predictive value. Results The general data showed that the patients in PNI≥45 group had higher age, BMI, postoperative complications, serum PTH and BLAP content, and lower bone mineral density and low Harris score than those in PNI≥45 group, and the difference was statistically significant (P<0.05). However, there were no significant differences in other indexes between the two groups (P>0.05). The nutritional and immune related hematological indexes (HGB, TP, ALB, LYMPH, RBC, and PALB) and BMI, Harris scores of patients with different PNI groups were compared longitudinally in different time periods. There were significant differences within and between groups (P<0.05, P<0.01). The results of multivariate analysis showed that PNI (HR=1.26, 95%CI:0.89-2.01, P<0.001, standardized partial regression coefficient=0.055) had the highest contribution, and was an independent risk factor for predicting prognosis. Moreover, Kappa coefficient indicated that PNI was consistent with Harris screening evaluation results (P<0.001). Conclusion PNI is an independent influential factor in the elderly patients with osteoporosis after hip replacement. It is of great significance to predict the outcome of hip replacement in the elderly patients with osteoporosis and to analyze the influencing factors. |