Abstract text (incl. references and figure legends)
Geriatric patients with a hip fracture are at risk for adverse outcomes after hip surgery. Identification of an imbalance in the innate immune response to injury, as measured by neutrophil phenotype and responsiveness, could help identify frail patients that might not benefit from surgical treatment of a hip fracture. In this study we aim to investigate post hip fracture changes in the neutrophil compartment at the emergency department (ED) for geriatric hip fracture patients.
Geriatric trauma patients with a hip fracture presented at the ED of a large regional teaching hospital, had one extra blood tube withdrawn and analyzed by a Point-of-Care flow cytometer. Neutrophil responsiveness to fNLF of geriatric hip fracture patients was compared to healthy controls. Patients with severe adverse events were compared with patients without adverse events.
Up to know, 48 blood samples were succesfully analyzed. Compared to healthy controls, geriatric trauma patients showed elevated baseline CD10 and CD11b and decreased CD62L levels. Neutrophils were decreased responsive to fNLF-activation regarding CD10 and CD11b upregulation. Patients that developed severe adverse outcomes have decreased responsiveness of CD10 and CD11b on admission at the ED.
This study shows that the assessment of the neutrophil compartment in geriatric hip fracture patients is feasible and revealed distinct activation patterns. Although power for statistical, clinical relevance is missing, this study is a first step toward immuno-based precision medicine for identifying frail patients with a high risk of severe adverse outcomes after surgery.
We are currently continuing this research in a larger trauma geriatric cohort to be able to present more clinical relevant data at the congress.
Figure 1. Neutrophil responsiveness (MFI fNLF+/MFI fNLF-) for geriatric hip fracture patients and healthy controls. Subgroup analyses compare patients with/withour severe adverse events.
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