Department of Orthopedic Surgery, Zhongshan Hospital Xiamen Branch, Fudan University, Fujian, China.
Shanghai Center for Clinical Laboratory, Shanghai, China.
Int J Clin Pract. 2021 Dec;75(12):e14791. doi: 10.1111/ijcp.14791. Epub 2021 Sep 23.
We aimed to determine whether pretreatment red blood cell distribution width (RDW) is an efficient predictor of 30-day mortality in older patients undergoing hip fracture surgery.
In this prospective cohort study, 203 patients with hip fractures were eligible and followed up for at least 30 days. All the patients underwent medical examinations. RDW was measured using an automated hematology analyzer. To evaluate the prognostic significance of RDW, Cox proportional hazard model and Kaplan-Meier analyses were performed.
Of the 203 patients (114 men, 89 women), 28 (13.79%) died within 30 days. The mean RDW was significantly higher in the deceased group than in the survival group (14.54% ± 1.09% vs 13.26% ± 0.57%; P < .001). Multivariate Cox regression analysis showed that elevated RDW (hazard ratio = 2.73, 95% confidence interval = 2.06-3.62, P < .001) was the key predictor of 30-day mortality in older patients undergoing hip fracture surgery. Survival analysis showed that patients with a high RDW had a significantly higher 30-day mortality rate (log-rank test, P < .05). Similar results were observed in the male and female subgroups.
RDW might be an effective predictor of 30-day mortality in older patients undergoing hip fracture surgery.
本研究旨在确定术前红细胞分布宽度（RDW）是否可有效预测行髋部骨折手术的老年患者 30 天死亡率。
在这项前瞻性队列研究中，203 例髋部骨折患者符合条件，并至少随访 30 天。所有患者均接受了体格检查。采用自动化血液分析仪测量 RDW。为评估 RDW 的预后意义，进行了 Cox 比例风险模型和 Kaplan-Meier 分析。
在 203 例患者（114 例男性，89 例女性）中，28 例（13.79%）在 30 天内死亡。死亡组的平均 RDW 明显高于存活组（14.54%±1.09%比 13.26%±0.57%；P<0.001）。多变量 Cox 回归分析显示，升高的 RDW（危险比=2.73，95%置信区间=2.06-3.62，P<0.001）是行髋部骨折手术的老年患者 30 天死亡率的关键预测因素。生存分析显示，RDW 较高的患者 30 天死亡率显著更高（对数秩检验，P<0.05）。在男性和女性亚组中也观察到了类似的结果。
RDW 可能是预测行髋部骨折手术的老年患者 30 天死亡率的有效指标。
