Department of Emergency Medicine, University of Health Sciences, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Department of Orthopedic Surgery, University of Health Sciences, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Turkey.
PeerJ. 2023 Sep 8;11:e16008. doi: 10.7717/peerj.16008. eCollection 2023.
Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. To investigate the effects of admission and post-operative levels of distribution width of red blood cells (RDW), albumin, and RDW/albumin (RA) ratio on predicting 1-year mortality following hip fracture surgery.
A retrospective study was conducted on 275 elderly patients who underwent hip fracture surgery in a tertiary hospital between January 2018 and January 2022. Deaths within one year of hip fracture were defined as the deceased group. The survivors were defined as those who survived for at least one year. The relationship between admission and post-operative levels of RDW, albumin, RA, and mortality within one year after hip surgery was assessed statistically, including binary logistic regression analysis. The study also assessed other factors related to mortality.
One-year mortality was 34.7%. There was a 3.03-year (95% CI [1.32-4.75]) difference between the deceased (79.55 ± 8.36 years) and survivors (82.58 ± 7.41 years) ( < 0.001). In the deceased group, the mean hemoglobin (HGB) values at admission ( = 0.022) and post-operative ( = 0.04) were significantly lower. RDW values at admission ( = 0.001) and post-op ( = 0.001) were significantly lower in the survivor group. The mean albumin values at admission ( < 0.001) and post-operative ( < 0.001) in the survivor group were significantly higher than in the deceased group. A significant difference was found between the survivor group and the deceased group in terms of mean RA ratio at admission and post-operative ( < 0.001). Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD) (OR 3.73, 95% CI [1.8-7.76]), RDW (OR 1.78, 95% CI [1.48-2.14]), and albumin (OR 0.81, 95% CI [0.75-0.87]), values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture.
Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly.
了解死亡率的危险因素对于降低老年髋部骨折患者的死亡率至关重要。本研究旨在探讨入院时和术后红细胞分布宽度（RDW）、白蛋白和 RDW/白蛋白（RA）比值水平对髋部骨折手术后 1 年死亡率的预测作用。
对 2018 年 1 月至 2022 年 1 月在一家三级医院接受髋部骨折手术的 275 名老年患者进行了回顾性研究。髋部骨折后 1 年内死亡的患者定义为死亡组，至少存活 1 年的患者定义为存活组。对入院时和术后 RDW、白蛋白、RA 水平与髋部骨折手术后 1 年内死亡率之间的关系进行了统计学评估，包括二项逻辑回归分析。该研究还评估了其他与死亡率相关的因素。
1 年死亡率为 34.7%。死亡组（79.55±8.36 岁）和存活组（82.58±7.41 岁）之间的年龄差异为 3.03 年（95%CI[1.32-4.75]）（<0.001）。死亡组入院时（=0.022）和术后（=0.04）的平均血红蛋白（HGB）值显著较低，而存活组入院时（=0.001）和术后（=0.001）的 RDW 值显著较低。存活组入院时（<0.001）和术后（<0.001）的平均白蛋白值显著高于死亡组。存活组和死亡组入院时和术后的平均 RA 比值存在显著差异（<0.001）。基于二项逻辑回归分析，发现慢性阻塞性肺疾病（COPD）（OR 3.73，95%CI[1.8-7.76]）、RDW（OR 1.78，95%CI[1.48-2.14]）和白蛋白（OR 0.81，95%CI[0.75-0.87]）在入院时的存在是老年髋部骨折患者 1 年死亡率的独立预测因素。
基于本研究，COPD、入院时较高的 RDW 和较低的白蛋白水平是老年髋部骨折手术后 1 年死亡率的独立预测因素。
