Objective To analyze the predictive value of preoperative C-reactive protein(CRP)to albumin(Alb)ratio(CRP/Alb)for postoperative mortality within 1 year in elderly patients(≥ 80 years)with hip fracture.Methods The medical records of 401 patients aged ≥80 years who underwent surgical treatment for hip fracture in Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2019 were retrospectively analyzed.There were 134 males and 267 females.The age was 80-99 years,and the aver-age age was 85.27±4.02 years.The mortality of the patients 1 year after operation was calculated by telephone follow-up or outpatient reexamination,the patients were divided into survival group(314 cases)and death group(87 cases).Factors that may affect patient sur-vival,including age,gender,operation mode,fracture type,American Society of Anesthesiology(ASA)grade,number of preoperative medical complications and preoperative laboratory indicators,including red blood cell count,white blood cell count,platelet count,hemo-globin,CRP and Alb were collected,and the CRP/Alb was calculated.Univariate analysis was performed for the above factors,and then the factors with statistically significant differences were further included in multivariate Logistic regression analysis,and area under the curve(AUC)of CRP,Alb and CRP/Alb were compared.Results A total of 401 patients in the group,87 patients died within 1 year after operation,the mortality rate was 21.70％.Univariate analysis showed that age,ASA grade,number of preoperative medical compli-cations,hemoglobin,white blood cell count,CRP,Alb,and CRP/Alb were the risk factors for death within 1 year after operation in eld-erly patients with hip fracture.Multivariate Logistic regression analysis showed that CRP,Alb,CRP/Alb,age,ASA grade and the num-ber of medical complications were independent risk factors for death within 1 year after operation in elderly patients with hip fracture(OR were 1.016,0.918,1.603,1.095,2.915,3.371,P＜0.05).The AUC of CRP,Alb and CRP/Alb for predicting postoperative death within 1 year in elderly patients with hip fracture were 0.783,0.719 and 0.814,respectively.Conclusion Compared with CRP and Alb,CRP/Alb is more valuable in predicting postoperative death in elderly patients(≥ 80 years)with hip fracture.