Clinical Interventions in Aging (Sep 2022)

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

  • Cheng X,
  • Fan L,
  • Hao J,
  • He H,
  • Yan J,
  • Zhu Y

Journal volume & issue
Vol. Volume 17
pp. 1319 – 1329

Abstract

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Xinqun Cheng,1,2,* Lingjia Fan,3,* Jiabei Hao,4 Honghou He,4 Jincheng Yan,1,2 Yanbin Zhu1,2 1Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China; 2Hebei Orthopedic Research Institute, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, People’s Republic of China; 3Department of Orthopadic Surgery, Shandong First Medical University, Jinan, 250000, People’s Republic of China; 4Basic Medical College, Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jincheng Yan; Yanbin Zhu, Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China, Email [email protected]; [email protected]: Deep vein thrombosis (DVT) is a devastating complication in geriatric patients before hip fracture surgery, and the predictive value of red cell distribution width (RDW) and high-density lipoprotein cholesterol (HDL-C) for DVTs after hip fracture remains to be established. This study aimed to assess the predictive value of RDW, HDL-C, and RDW-to-HDL-C ratio (RHR) in preoperative DVTs screening.Methods: We retrospectively analyzed the data of geriatric patients (≥ 65 years old) admitted for hip fracture surgery between 2015 and 2020. The receiver operating characteristic (ROC) curve and related parameters were used to evaluate the predictive value of the biomarkers. Patients were divided into two groups according to the cutoff value of RHR, and propensity score matching (PSM) and subgroup analyses were performed to assess the true correlations between RHR and DVT.Results: Among 2566 eligible patients included, we identified RDW with the area under ROC curve (AUC) of 0.532, cut-off value of 15.89, specificity of 88.2%, sensitivity of 18.2%, HDL-C with AUC of 0.574, cut-off value of 1.20, specificity of 55.6%, sensitivity of 59.3%, and RHR with AUC of 0.578, cut-off value of 13.45, specificity of 71.3%, sensitivity of 43.4%. RHR (> 13.45) was independently associated with 1.54-fold risk (95% CI: 1.11– 2.14, P=0.011) of DVTs among the post-PSM cohort. And compared with the counterparts, the relative risk of RHR associated with DVT was higher in the subgroups of aged 65– 79 years (1.61 vs 1.45), non-hypoproteinemia (2.70 vs 1.29), non-diabetic (1.58 vs 1.41), non-hypertension (2.40 vs 1.06), ASA score I-II (2.38 vs 1.04), and femoral neck fracture (1.70 vs 1.50).Conclusion: RDW, HDL-C and RHR were valuable biomarkers in predicting preoperative DVTs in geriatric patients with hip fracture, and RHR would be more efficient in the subgroups of younger age, better medical condition or femoral neck fracture.Keywords: geriatric patients, hip fracture, deep vein thrombosis, red cell distribution width, high-density lipoprotein cholesterol

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