2026 Volume 53 Issue 1 Pages 49-55
Objective: This study aimed to clarify the association between serum albumin levels at hospital admission and ambulatory independence at discharge in older patients with hip fractures (HFs), stratified by the presence and degree of polypharmacy.
Methods: We retrospectively analyzed 243 postoperative patients aged ≥75 years who underwent surgery for HFs. Patients were stratified into three groups based on the number of regularly prescribed oral medications: non-polypharmacy (<6 drugs), polypharmacy (≥6 drugs), and hyper-polypharmacy (≥10 drugs). Ambulatory independence was defined as achieving a Functional Ambulation Categories (FAC) score of ≥3 at discharge. Multivariable logistic regression analyses were conducted separately within each group, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Receiver operating characteristic curve analysis was performed to evaluate predictive performance, summarized by the area under the curve (AUC).
Results: The proportion of patients achieving FAC scores of ≥3 at discharge was 47.1% in the non-polypharmacy group, 39.9% in the polypharmacy group, and 39.7% in the hyper-polypharmacy group. Serum albumin levels were significantly associated with achieving FAC scores ≥3 in the polypharmacy group (OR, 2.49; 95% CI, 1.35–4.80) and the hyper-polypharmacy group (OR, 3.59; 95% CI, 1.31–11.54), but not in the non-polypharmacy group. The highest predictive accuracy was observed in the hyper-polypharmacy group (AUC=0.67).
Conclusion: Serum albumin levels at admission may have limited predictive value in patients without polypharmacy but appear to be particularly informative for predicting ambulatory independence, defined as achieving FAC scores of ≥3 at discharge, among older patients with polypharmacy or hyper-polypharmacy.
