Red cell distribution width as mortality prognostic factor in patients 65 and older with hip fracture

Abstract

Red cell distribution width (RDW) has been suggested as a significant prognostic factor of mortality in cardiovascular diseases. However, a link between RDW at patient admission and mortality among hip fracture patients has not been fully investigated.

Objective: To determine the prognostic value of RDW in patients with hip fracture and its association with selected variables such as unfavorable functional grade, postoperative complications, comorbidities, previous fracture, age and sex.

Method. A clinical trial with both retrospective and prospective components study was carried out among 99 patients hospitalized at the Hospital Central de la Fuerza Aérea del Perú [Central Hospital of the Peruvian Air Force], from January 2014 to July 2015, with a follow-up at 6 months for the evaluation of mortality and degree of dependence. RDW and association with related variables was investigated.

Results: High RDW values ​​(Q4 RDW> 14.1) were strongly associated with increased mortality (OR = 5.41 CI: 2.35-12.46 p = 0.000) and with an increased patient dependence grade(OR = 1.607 CI : 1.074-2.44 p = 0.040)., with respect to the other quartiles. A positive trend was observed with the highest RDW values and the antecedent of previous fracture showed a significant association with mortality at 6 months.

Conclusion: RDW is a simple, easy and widely available parameter in the total red blood cell count. Our study shows that both the RDW and the antecedent of previous fracture are associated with an increased risk of mortality at 6 months after discharge, in addition RDW is associated with an increase in patience dependence after hip fracture.