Prevalence and correlative factors of hyperhomocysteinemia in elderly patients with femoral neck fracture: A cross-sectional study.

ABSTRACT

AIMS: The occurrence of hyperhomocysteinemia (HHcy) in elderly patients with femoral neck fracture (FNF) draws little attention from surgeons preoperatively. The aim of our study was to determine the prevalence and correlative factors of HHcy in elderly patients (≥65 years) with FNF prior to surgery. METHODS: We retrospectively investigated 286 elderly FNF patients aged 65-98 years admitted to our institution from September 2020 to September 2021. Categorical variables were compared using the Chi-squared test, and continuous variables were compared using the Mann-Whitney U test. Univariable and multivariable logistic regression were used to determine the associations of variables with the odds of HHcy. RESULTS: Among the 286 elderly FNF patients, the prevalence of HHcy was 30.77% and the mean Hcy level was 14.52 ± 10.49 µmol/L. The mean Hcy level and the prevalence of HHcy in male patients were significantly higher than that in female patients (16.41 ± 9.58 µmol/L vs. 14.00 ± 10.69 µmol/L, p = 0.002; 43.55% vs. 27.23%, p = 0.014). Multivariate analysis indicated that being male patient (OR 2.187, 95% CI 1.187-4.028, p = 0.012), hypertension (OR 1.993, 95% CI 1.141-3.479, p = 0.015), and low HDL-C (OR 2.979, 95% CI 1.353-6.558, p = 0.007) were significant correlative factors of HHcy among elderly FNF patients. CONCLUSIONS: This study found a high prevalence of HHcy in elderly FNF patients, with being male patient, hypertension, and low levels of HDL-C as the significant correlative factors after adjusting for age and other covariables. However, further large-scale studies in wider regions are warranted to confirm these findings.