Association between total cholesterol and all-cause mortality in geriatric patients with hip fractures: A prospective cohort study with 339 patients

Background. Total cholesterol (TC) levels represent the comprehensive level of human cholesterol metabolism, which is closely related to the nutritional status, metabolic level, disease development, and aging of the human body. Total cholesterol plays an important role in the maintenance of bodily functions, regulation of sexual function, immune regulation, and in the development of organisms. Abnormal TC levels are an important risk factor for cardiovascular disease (CVD), and TC is closely related to the development of many diseases, and is used as an important indicator of human blood lipid levels and overall health status. However, the relationship between serum TC levels and the prognosis of patients with hip fractures remains unclear. Objectives. To evaluate the association between TC levels and all-cause mortality in patients with geriatric hip fractures. Materials and methods. Elderly patients with hip fractures were screened between January 2015 and September 2019. Patient demographic and clinical characteristics were recorded. Linear multivariate Cox regression models were used to identify the association between TC levels and all-cause mortality. Analyses were performed using Empower Stats and R software. Results. Three hundred and thirty-nine patients were enrolled. The mean follow-up period was 34.18 months. There were 99 (29.20%) cases of all-cause mortality. Total cholesterol levels after hip fracture were linearly associated with all-cause mortality in the elderly. Linear multivariate Cox regression models showed that TC levels were associated with mortality (hazard ratio (HR) = 0.67; 95% confidence interval (95% CI): 0.53-0.85; p = 0.001 after adjusting for confounding factors). Each 1 mmol/L increase in TC levels was associated with a 33% reduction in morbidity and mortality. Compared with the low-TC group, mortality was significantly lower in the middle-TC group (HR = 0.58; 95% CI: 0.35-0.94; p = 0.027) and high-TC group (HR = 0.45; 95% CI: 0.27-0.75; p = 0.002). Conclusions. Total cholesterol levels were associated with mortality in geriatric hip fracture patients and could be considered a protective factor for all-cause mortality.