{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:05:53Z","timestamp":1784264753985,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hip fracture (HF) is a fragility fracture associated with a high risk of death in older adults. The blood urea nitrogen to albumin ratio (BAR) may reflect renal function and perfusion status, metabolic stress, and nutritional reserve, but its prognostic value in older patients with hip fracture remains unclear. This study aimed to evaluate the association between BAR and the risk of 1-year all-cause mortality after HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included patients aged 60 years or older who underwent surgery for HF between May 2016 and December 2021. Several inflammation and nutrition related composite indicators were calculated using laboratory tests obtained early after admission. Logistic regression analysis was used to evaluate the associations between these indicators and 1-year mortality after HF. Restricted cubic spline (RCS) analysis, area under the receiver operating characteristic curve (AUC), sensitivity analysis, and subgroup analysis were further performed to assess the dose response relationship, predictive performance, and robustness of BAR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 521 patients were included, of whom 77 died within 1 year after hip fracture, corresponding to a mortality rate of 14.8%. In univariate analysis, SIRI, AISI, HALP, PNI, BAR, and NPAR were associated with mortality risk. After further adjustment for demographic characteristics, fracture related factors, surgical duration, and candidate confounders, only BAR remained consistently associated with mortality. In model 3, higher BAR was associated with an increased risk of 1-year all-cause mortality after hip fracture (OR = 1.13, 95% CI: 1.05\u20131.22,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.01). RCS analysis did not show a significant nonlinear association. The AUC of BAR was 0.67, which was higher than that of BUN and ALB. No significant interaction was observed in subgroup analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher BAR early after admission was associated with an increased risk of 1-year mortality in older patients with hip fracture. BAR may serve as a simple and low-cost auxiliary indicator for risk stratification, although its predictive performance was moderate and requires further validation in multicenter prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1877434","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:23:15Z","timestamp":1784262195000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood urea nitrogen to albumin ratio and 1-year mortality after hip fracture surgery in older adults: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jian","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Fourth Affiliated Hospital of Anhui Medical University","place":["Hefei, 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