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红细胞分布宽度与髋部骨折后死亡率风险的关系:一项荟萃分析。

The Association between Red Blood Cell Distribution Width and Mortality Risk after Hip Fracture: A Meta-Analysis.

机构信息

The International Graduate Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.

Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam.

出版信息

Medicina (Kaunas). 2024 Mar 14;60(3):485. doi: 10.3390/medicina60030485.


DOI:10.3390/medicina60030485
PMID:38541211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10972257/
Abstract

: Hip fractures in the elderly pose a considerable health risk and cause concern. Red blood cell distribution width (RDW) is a valuable marker for identifying patients at high risk of age-related mortality and various disorders and diseases. However, its association with poor patient outcomes following hip fractures has yet to be fully established. Hence, the purpose of this meta-analysis was to investigate and gain a better understanding of the relationship between RDW levels and the risk of mortality after hip fractures. : PubMed, Embase, Web of Science, and other databases were comprehensively searched until April 2023 to identify relevant studies. The meta-analysis included observational studies finding the association between RDW at admission or preoperation and short-term and long-term mortality rates following hip fractures. The results were presented in terms of odds ratios (ORs) or hazard ratios (HRs) with corresponding 95% confidence intervals (CIs). : This meta-analysis included 10 studies involving 5834 patients with hip fractures. Patients with preoperative RDW of over 14.5% had higher risks of 1-year (OR: 5.40, 95% CI: 1.89-15.48, = 0.002) and 3-month (OR: 2.91, 95% CI: 1.42-5.95, = 0.004) mortality. Higher admission or preoperative RDW was significantly associated with an 11% higher mortality risk after 1 year (HR: 1.11, 95% CI: 1.06-1.17, < 0.00001). Patients with higher preoperative RDW had a significantly higher risk of 6-month mortality, which was three times that of those with lower preoperative RDW (OR: 3.00, 95% CI: 1.60-5.61, = 0.0006). Higher preoperative RDW was correlated to a higher 30-day mortality risk (OR: 6.44, 95% CI: 3.32-12.47, < 0.00001). : Greater RDW values at admission or before surgery were associated with a higher risk of short-term and long-term mortality following hip fractures. Because RDW can be easily measured using a routine blood test at a low cost, this parameter is promising as an indicator of mortality in elderly patients with hip fractures.

摘要

老年人髋部骨折存在相当大的健康风险,并令人担忧。红细胞分布宽度(RDW)是识别与年龄相关的死亡率和各种疾病风险较高的患者的有价值的标志物。然而,其与髋部骨折后患者预后不良之间的关系尚未完全确定。因此,本荟萃分析的目的是研究和更好地了解 RDW 水平与髋部骨折后死亡率之间的关系。

我们全面检索了 PubMed、Embase、Web of Science 和其他数据库,以确定相关研究,检索截至 2023 年 4 月。荟萃分析纳入了观察性研究,这些研究发现入院或术前 RDW 与髋部骨折后短期和长期死亡率之间的关系。结果以比值比(OR)或风险比(HR)及其相应的 95%置信区间(CI)表示。

本荟萃分析纳入了 10 项研究,共纳入 5834 例髋部骨折患者。术前 RDW 超过 14.5%的患者,1 年(OR:5.40,95%CI:1.89-15.48, = 0.002)和 3 个月(OR:2.91,95%CI:1.42-5.95, = 0.004)死亡率风险更高。较高的入院或术前 RDW 与 1 年后死亡率增加 11%显著相关(HR:1.11,95%CI:1.06-1.17, < 0.00001)。术前 RDW 较高的患者,6 个月死亡率显著更高,是术前 RDW 较低患者的 3 倍(OR:3.00,95%CI:1.60-5.61, = 0.0006)。术前 RDW 与 30 天死亡率风险增加相关(OR:6.44,95%CI:3.32-12.47, < 0.00001)。

因此,入院或术前 RDW 值较高与髋部骨折后短期和长期死亡率风险增加相关。由于 RDW 可以通过常规血液检查以低成本进行测量,因此作为老年髋部骨折患者死亡率的预测指标具有很大的应用前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/a3d6fb82f15c/medicina-60-00485-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/12386aad6a4a/medicina-60-00485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/8b1cbb31bf27/medicina-60-00485-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/8e329f7ef49e/medicina-60-00485-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/df358393af7d/medicina-60-00485-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/a3d6fb82f15c/medicina-60-00485-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/12386aad6a4a/medicina-60-00485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/8b1cbb31bf27/medicina-60-00485-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/8e329f7ef49e/medicina-60-00485-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/df358393af7d/medicina-60-00485-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0293/10972257/a3d6fb82f15c/medicina-60-00485-g005.jpg

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Front Med (Lausanne). 2025-7-10

[2]
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[3]
The Second Hip Fracture is not an Independent Predictor of Poor Outcomes in Elderly Patients - A Case-Control Study.

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[4]
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本文引用的文献

[1]
Study of the link between hemotopoietic and skeletal systems in patients attending a referral center for osteoporosis.

J Endocrinol Invest. 2023-11

[2]
Correlation between C-reactive protein and postoperative mortality in patients undergoing hip fracture surgery: a meta-analysis.

J Orthop Surg Res. 2023-3-9

[3]
The Role of Red Cell Distribution Width as a Prognostic Marker in Chronic Liver Disease: A Literature Review.

Int J Mol Sci. 2023-2-9

[4]
Physical Frailty and Hemoglobin-to-Red Cell Distribution Width Ratio in Japanese Older Outpatients.

J Frailty Aging. 2022

[5]
Predicting mortality rate in elderly patients operated for hip fracture using red blood cell distribution width, neutrophil-to-lymphocyte ratio, and Nottingham Hip Fracture Score.

Jt Dis Relat Surg. 2022

[6]
Diagnostic value of RDW for the prediction of mortality in adult sepsis patients: A systematic review and meta-analysis.

Front Immunol. 2022

[7]
AAOS Management of Hip Fractures in Older Adults Evidence-based Clinical Practice Guideline.

J Am Acad Orthop Surg. 2022-10-15

[8]
Handgrip Strength as a Predictor of Successful Rehabilitation After Hip Fracture in Patients 65 Years of Age and Above.

Clin Interv Aging. 2022

[9]
Red Cell Distribution Width-to-High-Density Lipoprotein Cholesterol Ratio (RHR): A Promising Novel Predictor for Preoperative Deep Vein Thrombosis in Geriatric Patients with Hip Fracture.

Clin Interv Aging. 2022

[10]
Red blood cell distribution width is associated with increased interactions of blood cells with vascular wall.

Sci Rep. 2022-8-11

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