Pretreatment red blood cell distribution width as an efficient predictor of survival in older patients undergoing hip fracture surgery

Int J Clin Pract. 2021 Dec;75(12):e14791. doi: 10.1111/ijcp.14791. Epub 2021 Sep 23.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: RDW might be an effective predictor of 30-day mortality in older patients undergoing hip fracture surgery.

MeSH terms

  • Aged
  • Erythrocyte Indices*
  • Erythrocytes
  • Female
  • Hip Fractures* / surgery
  • Humans
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Retrospective Studies