{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:49:30Z","timestamp":1787240970620,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The assessment and identification of elderly patients with proximal femur fractures (PFF) who are at high risk of postoperative mortality may influence the treatment decision-making process. The purpose of this study was to determine whether the neutrophil-to-lymphocyte ratio (NLR) could be used to predict postoperative mortality in the elderly population. Methods: A four-year retrospective cohort study of electronic medical records was conducted at a single tertiary care hospital between 2015 and 2018. Data from 1551 patients aged 65 years and older who underwent surgical treatment for PFF were collected and analyzed. The data included complete blood counts at admission, demographic information, underlying illnesses, type of surgery, and postoperative mortality and complications during the first year of follow-up. A survival analysis model was utilized. Results: The mean age was 90.76 \u00b1 1.88 years, 1066 (68.7%) women. Forty-four (2.8%) patients experienced postoperative infection. A higher NLR0 was independently associated with higher all-cause mortality rates in patients who underwent surgical treatment for PFF (p = 0.041). Moreover, the mean NLR0 value was higher when the death occurred earlier after surgery (p &lt; 0.001). Conclusions: When combined with other clinical and laboratory findings, NLR0 levels may serve as a potentially valuable, inexpensive, and reliable prognostic biomarker to improve risk stratification for elderly patients who are candidates for PFF surgery. Furthermore, with additional research, we could potentially develop a treatment algorithm to identify patients at high risk of postoperative mortality.<\/jats:p>","DOI":"10.3390\/jcm12020456","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T02:20:30Z","timestamp":1672971630000},"page":"456","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Proximal Femur Fractures in the Elderly\u2014A Novel Modality to Predict Mortality: The Neutrophil-to-Lymphocyte Ratio"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7792-0951","authenticated-orcid":false,"given":"Omer","family":"Marom","sequence":"first","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbar","family":"Paz","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Segal","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Topaz","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitzan","family":"Abelson","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Tavdi","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refael","family":"Behrbalk","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezequiel","family":"Palmanovich","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nissim","family":"Ohana","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Yaacobi","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/PL00004148","article-title":"World-wide projections for hip fracture","volume":"7","author":"Gullberg","year":"1997","journal-title":"Osteoporos Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00198-004-1627-0","article-title":"An estimate of the worldwide prevalence, mortality and disability associated with hip fracture","volume":"15","author":"Johnell","year":"2004","journal-title":"Osteoporos Int."},{"key":"ref_3","first-page":"660","article-title":"Epidemiological characteristics and causes of proximal femur fractures among the elderly","volume":"46","author":"Neto","year":"2011","journal-title":"Rev. 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