红细胞分布宽度与老年髋部脆性骨折患者近期病死率的关系

Relationship between red blood cell distribution width and short-term mortality of hip fractures in the

目的探讨红细胞分布宽度(RDW)与老年髋部脆性骨折患者近期病死率的关系。方法回顾分析2020年至2021年入住我院且获得随访满1年的205例老年髋部脆性骨折患者基本资料及入院时初次血常规,统计患者内科合并症、RDW及骨折后6个月及1年累计病死率,分析RDW与髋部脆性骨折近期病死率的关系。结果≤1种内科合并症患者6个月(6.7%和20.8%,χ^(2)=8.591,P=0.003)、1年(6.7%和26.7%,χ^(2)=14.818,P<0.001)的病死率均明显低于≥2种内科合并症患者。RDW>13.5%组6个月及1年病死率都显著高于RDW≤13.5%组。≥2种内科合并症患者其RDW>13.5%的比例高于≤1种内科合并症患者。以RDW=13.6%为6个月及1年病死率的截断值,其预测6个月死亡风险的敏感度为71.4%,特异度为59.9%,预测1年死亡风险的敏感度为64.7%,特异度为59.6%。结论RDW与脆性髋部骨折近期病死率相关,RDW越大,死亡风险越高。

Objective To study the relationship between red blood cell distribution width(RDW)and short-term mortality in elderly patients with hip fragility fractures.Methods The clinical data and blood routine test at admission of 205 elderly patients with brittle hip fractures who were admitted to our hospital from 2020 to 2021 and were followed up for one year were retrospectively analyzed.The comorbid conditions,RDW and cumulative mortality at 6 months and 1 year after fractures were counted,and the relationship between RDW and short-term mortality were analyzed.Results The 6-month(6.7% and 20.8%,χ^(2)=8.591,P=0.003)and 1-year(6.7% and 26.7%,χ^(2)=14.818,P<0.001)mortality of patients with≤1 comorbidity were significantly lower than those of patients with≥2 comorbidities.Moreover,the 6-month and 1-year mortality in patients with RDW>13.5% were significantly higher than those of patients with RDW≤13.5%.The proportion of RDW>13.5% in patients with at least two comorbidities was significantly higher than that in patients with≤1 comorbidity.Taking RDW=13.6% as the cut-off value of 6-month and 1-year mortality,the sensitivity and specificity for predicting 6-month mortality were 71.4% and 59.9%,respectively,and the sensitivity and specificity for predicting l-year mortality were 64.7% and 59.6%,respectively.ConclusionsRed cell distribution width is associated with short-term mortality,and higher RDW is associated with a higher risk of mortality among elderly patients with brittlehip fractures.