Red Cell Distribution Width as an Independent Predictor of Long‐Term Mortality in Hip Fracture Patients: A Prospective Cohort Study |
| |
| Authors: | Anhua Long Zhi Mao Jing Shen Pengbin Yin Ming Li Chao Zeng Lihai Zhang Peifu Tang |
| |
| Affiliation: | 1. Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China;2. School of Medicine, Nankai University, Tianjin, China;3. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China |
| |
| Abstract: | Red blood cell distribution width (RDW) has been found to be a significant prognostic factor of mortality in many cardiovascular diseases. However, a link between RDW at admission with long‐term mortality in the hip fracture population has not been well established. Therefore, we sought to evaluate the long‐term prognostic value of RDW in a well‐defined hip fracture cohort, and to compare the effect of RDW in patients with and without anemia. A prospective cohort study was performed on 1479 hip fracture patients admitted at the General Hospital of Chinese PLA between January 2000 and October 2011 with a follow‐up study over a 2‐year period. A total of 1479 patients were used for the evaluation of 2‐year all‐cause mortality, while 804 patients with more than 4 years of follow‐up were extracted for further evaluation of 4‐year all‐cause mortality. Cox proportional regression was used to evaluate the association between admission RDW and long‐term mortality, adjusting for potential confounding variables. Higher RDW values were strongly associated with increased all‐cause mortality. After adjusting for age, mean corpuscular volume, admission hemoglobin, comorbidities, and complications, RDW had a significant independent association with both 2‐year mortality with a hazard ratio (HR) of 1.183 (95% confidence interval [CI], 1.017 to 1.376) and 4‐year mortality with an HR of 1.244 (95% CI, 1.052 to 1.471). In stratified analysis, the effect of RDW was even more pronounced, with 2‐year mortality HR of 1.341 (95% CI, 1.095 to 1.643) and 4‐year mortality HR of 1.345 (95% CI, 1.071 to 1.688) in non‐anemic patients. In non‐anemic patients, elevated RDW values are significantly associated with increased odds of all‐cause mortality, implying that RDW may be a possible laboratory biomarker for risk stratification in non‐anemic hip fracture patients. Further studies are needed to confirm the current finding in different and larger hip fracture cohorts. © 2015 American Society for Bone and Mineral Research. |
| |
| Keywords: | RED BLOOD CELL DISTRIBUTION WIDTH ALL‐CAUSE MORTALITY HIP FRACTURE ANEMIA |
|
|
