Background: Hypoalbuminemia is common in older adults with hip fracture and may reflect nutritional reserve, inflammation, chronic disease, and acute illness. This study described preoperative serum albumin and examined its associations with perioperative outcomes in patients undergoing hip-fracture surgery.

Methods: This prospective observational study was conducted at B&B Hospital, Nepal. Preoperative albumin was classified as low (<3.5 g/dL) or normal (≥3.5 g/dL). Categorical variables were compared using Fisher exact tests where appropriate, and continuous variables using Welch two-sample t-tests. An exploratory parsimonious logistic regression assessed ICU/HDU admission, adjusting for age and preoperative ambulatory status.

Results: Mean age was 77.57 ± 10.90 years and 36/51 (70.6%) were female. Low albumin was present in 37/51 (72.5%). ICU/HDU admission occurred in 31/37 (83.8%) patients with low albumin and 5/14 (35.7%) with normal albumin (p=0.0016). Postoperative transfusion occurred in 37/37 (100%) and 11/14 (78.6%), respectively (p=0.0175). In the exploratory ICU/HDU model, the adjusted OR for low albumin was 2.67 (95% CI 0.49–14.48; p=0.255). No deaths were recorded. 

Conclusion: Low preoperative serum albumin was common and was associated with ICU/HDU admission and postoperative transfusion. 

Keywords: elderly; albumins; hip fractures; malnutrition; postoperative complications