The Association Between Red Cell Distribution Width (RDW) and All-Cause Mortality in Elderly Patients with Hip Fractures: A Retrospective Cohort Study

Abstract

Neng-Jun Wang,* Yu-Min Zhang,* Bin-Fei Zhang Department of Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bin-Fei Zhang, Email [email protected]: Red cell distribution width (RDW) may be related to the prognosis of hip fractures. The purpose of this study was to evaluate the association between (RDW) and all-cause mortality in elderly hip fractures.Materials and Methods: Elderly patients aged ≥ 65 years who had a hip fracture were screened between January 1, 2015, and September 30, 2019. The age, gender of patients and other demographics, as well as history of allergy, injury mechanism, underlying illnesses at the time of admission, fracture classification, time from admission to operation, RDW, operation time, blood loss, infusion, transfusion, treatment strategy, and length in hospital stay and follow-up and other clinical characteristics were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between RDW and mortality in these patients. Analyses were performed using EmpowerStats and the R software.Results: A total of 2587 patients were included in this retrospective cohort study. The mean follow-up period was 38.92 months. A total of 873 (33.75%) patients died due to all-cause mortality. The RDW was linearly associated with mortality in elderly patients with hip fractures. Linear multivariate Cox regression models showed that RDW was associated with mortality (hazard ratio [HR]=1.03, 95% confidence interval [CI]:1.02– 1.05, P < 0.0001) after adjusting for confounding factors. The mortality risk increased by 3% when RDW increased by 1 fL.Conclusion: RDW is associated with mortality in elderly patients with hip fractures, and RDW could be considered a predictor of mortality risk.Registration: ChiCTR2200057323.Keywords: all-cause mortality, red cell distribution width, hip fracture

Keywords

• all-cause mortality
• red cell distribution width
• hip fracture