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一项回顾性队列研究：老年髋部骨折患者的红细胞体积大小的变异系数(RDW-CV)与全因死亡率之间的关系
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Abstract:
介绍：本研究旨在评估红细胞体积大小的变异系数(RDW-CV)与老年人髋部骨折全因死亡率之间的关系。方法：对2015年1月至2019年9月期间在西安市红会医院接受治疗的老年髋部骨折患者进行筛选。收集患者的年龄、性别等人群特征，以及损伤机制、入院基础疾病、骨折分类、从入院时间到手术、RDW-CV、手术时间、失血量、输液量、输血量、治疗策略、住院时间，随访时间等临床特征。使用多因素Cox回归模型来确定这些患者的RDW-CV和死亡率之间的关系。所有分析均使用EmpowerStats和R软件进行。结果：本回顾性队列研究共纳入2303例患者，并根据其RDW-CV水平分为三组。平均随访时间为39.23个月。RDW-CV的平均值为13.24 ± 0.48。患者一年后的全因死亡数为707例(30.69%)。多因素Cox回归模型显示，在排除了其他影响因素后，RDW-CV与老年髋部骨折患者的死亡率(风险比 = 1.13，95%置信区间：1.07~1.18，P < 0.0001)相关。当RDW-CV每增加1%时，患者的死亡风险增加了13%。结论：红细胞体积大小的变异系数(RDW-CV)与老年髋部骨折患者的全因死亡率相关，而RDW-CV可被认为是死亡风险的预测因子。
Introduction: The purpose of our study was to evaluate the relationship between the coefficient of variation of red blood cell volume (RDW-CV) and the all-cause mortality of hip fracture in the elderly. Methods: The elderly patients with hip fracture who were treated in Xi’an Honghui Hospital from January 2015 to September 2019 were screened. The age, gender and other population characteristics of the patients were collected, as well as the injury mechanism, basic diseases at admission, fracture classification, RDW-CV, operation time, blood loss, infusion volume, blood transfusion volume, treatment strategy, hospitalization time, follow-up time and other clinical characteristics from admission time to operation. Multivariate Cox regression models were used to determine the relationship between RDW-CV and mortality in these patients. All analyses were performed using EmpowerStats and R software. Results: A total of 2303 patients were included in this retrospective cohort study and divided into three groups according to their RDW-CV levels. The average follow-up time was 39.23 months. The mean value of RDW-CV was 13.24 ± 0.48. The number of all-cause deaths after 1 year was 707 (30.69%). Multivariate Cox regression model showed that after excluding other influencing factors, RDW-CV was associated with mortality in elderly patients with hip fracture (hazard ratio = 1.13, 95% confidence interval: 1.07~1.18, P < 0.0001). When RDW-CV increased by 1%, the risk of death increased by 13%. Conclusion: The coefficient of variation of red blood cell volume size (RDW-CV) is associated with all-cause mortality in elderly patients with hip fracture, and RDW-CV can be considered as a predictor of death risk.
| [1] | Mattisson, L., Bojan, A. and Enocson, A. (2018) Epidemiology, Treatment and Mortality of Trochanteric and Subtrochanteric Hip Fractures: Data from the Swedish Fracture Register. BMC Musculoskeletal Disorders, 19, Article No. 369. https://doi.org/10.1186/s12891-018-2276-3 |
| [2] | García-Tercero, E., Belenguer-Varea, Á., Villalon-Ruibio, D., López Gómez, J., Trigo-Suarez, R., Cunha-Pérez, C., et al. (2024) Respiratory Complications Are the Main Predictors of 1-Year Mortality in Patients with Hip Fractures: The Results from the Alzira Retrospective Cohort Study. Geriatrics, 9, Article No. 47. https://doi.org/10.3390/geriatrics9020047 |
| [3] | Center, J.R., Nguyen, T.V., Schneider, D., Sambrook, P.N. and Eisman, J.A. (1999) Mortality after All Major Types of Osteoporotic Fracture in Men and Women: An Observational Study. The Lancet, 353, 878-882. https://doi.org/10.1016/s0140-6736(98)09075-8 |
| [4] | Duque-Sánchez, J., Toro, L., González-Gómez, F., Botero-Baena, S., Duque, G. and Gómez, F. (2022) One-Year Mortality after Hip Fracture Surgery: Urban-Rural Differences in the Colombian Andes. Archives of Osteoporosis, 17, Article No. 111. https://doi.org/10.1007/s11657-022-01150-5 |
| [5] | Wang, N., Zhang, Y. and Zhang, B. (2023) The Association between Red Cell Distribution Width (RDW) and All-Cause Mortality in Elderly Patients with Hip Fractures: A Retrospective Cohort Study. International Journal of General Medicine, 16, 3555-3566. https://doi.org/10.2147/ijgm.s417079 |
| [6] | Adeyemi, A. and Delhougne, G. (2019) Incidence and Economic Burden of Intertrochanteric Fracture: A Medicare Claims Database Analysis. JBJS Open Access, 4, e0045. https://doi.org/10.2106/jbjs.oa.18.00045 |
| [7] | Veronese, N. and Maggi, S. (2018) Epidemiology and Social Costs of Hip Fracture. Injury, 49, 1458-1460. https://doi.org/10.1016/j.injury.2018.04.015 |
| [8] | Li, Y., Xing, C., Wei, M., Wu, H., Hu, X., Li, S., et al. (2019) Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer. Journal of Cancer, 10, 1162-1170. https://doi.org/10.7150/jca.29018 |
| [9] | Salvagno, G.L., Sanchis-Gomar, F., Picanza, A. and Lippi, G. (2014) Red Blood Cell Distribution Width: A Simple Parameter with Multiple Clinical Applications. Critical Reviews in Clinical Laboratory Sciences, 52, 86-105. https://doi.org/10.3109/10408363.2014.992064 |
| [10] | Arkew, M., Gemechu, K., Haile, K. and Asmerom, H. (2022) Red Blood Cell Distribution Width as Novel Biomarker in Cardiovascular Diseases: A Literature Review. Journal of Blood Medicine, 13, 413-424. https://doi.org/10.2147/jbm.s367660 |
| [11] | Chen, Y., Hou, X., Zhong, J. and Liu, K. (2024) Association between Red Cell Distribution Width and Hypertension: Results from NHANES 1999-2018. PLOS ONE, 19, e0303279. https://doi.org/10.1371/journal.pone.0303279 |
| [12] | Shen, T., Yang, X. and Zhang, Z. (2022) Positive Relationship of RDW with NT-proBNP and cTnI in Acute Myocardial Infarction Patients. Clinical Laboratory, 68, 1. https://doi.org/10.7754/clin.lab.2021.210808 |
| [13] | Li, Y., Xing, C., Wei, M., Wu, H., Hu, X., Li, S., et al. (2019) Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer. Journal of Cancer, 10, 1162-1170. https://doi.org/10.7150/jca.29018 |
| [14] | Yang, K., Sun, B., Zhang, S., Pan, Y. and Fang, J. (2023) RDW-SD Is Superior to RDW-CV in Reflecting Liver Fibrosis Stage in Patients with Chronic Hepatitis B. Infection and Drug Resistance, 16, 6881-6891. https://doi.org/10.2147/idr.s427047 |
| [15] | Liu, Y., Wang, Z. and Xiao, W. (2017) Risk Factors for Mortality in Elderly Patients with Hip Fractures: A Meta-Analysis of 18 Studies. Aging Clinical and Experimental Research, 30, 323-330. https://doi.org/10.1007/s40520-017-0789-5 |
| [16] | Chang, W., Lv, H., Feng, C., Yuwen, P., Wei, N., Chen, W., et al. (2018) Preventable Risk Factors of Mortality after Hip Fracture Surgery: Systematic Review and Meta-Analysis. International Journal of Surgery, 52, 320-328. https://doi.org/10.1016/j.ijsu.2018.02.061 |
| [17] | Yin, P., Lv, H., Li, Y., Meng, Y., Zhang, L., Zhang, L., et al. (2018) Hip Fracture Patients Who Experience a Greater Fluctuation in RDW during Hospital Course Are at Heightened Risk for All-Cause Mortality: A Prospective Study with 2-Year Follow-Up. Osteoporosis International, 29, 1559-1567. https://doi.org/10.1007/s00198-018-4516-7 |
| [18] | Garbharran, U., Chinthapalli, S., Hopper, I., George, M., Back, D.L. and Dockery, F. (2012) Red Cell Distribution Width Is an Independent Predictor of Mortality in Hip Fracture. Age and Ageing, 42, 258-261. https://doi.org/10.1093/ageing/afs176 |
| [19] | Li, X., Chen, Q., Bi, X., Zhao, J., Li, Z., Zhou, J., et al. (2021) Preoperatively Elevated RDW-SD and RDW-CV Predict Favorable Survival in Intrahepatic Cholangiocarcinoma Patients after Curative Resection. BMC Surgery, 21, Article No. 105. https://doi.org/10.1186/s12893-021-01094-6 |
| [20] | Ertekin, B. and Acar, T. (2022) The Relationship between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease. International Journal of General Medicine, 15, 8637-8645. https://doi.org/10.2147/ijgm.s392453 |
| [21] | He, J., Zhang, Y., Hao, P., Li, T., Xiao, Y., Peng, L., et al. (2023) Association between Red Blood Cell Distribution Width and Long-Term Mortality in Patients with Intracerebral Hemorrhage. Neurocritical Care, 40, 1059-1069. https://doi.org/10.1007/s12028-023-01875-2 |
| [22] | Jin, F., Chang, X., Wang, X., Xiong, H., Wang, L., Zhang, B., et al. (2023) Relationship between Red Blood Cell-Related Indices and Coronary Artery Calcification. Postgraduate Medical Journal, 99, 4-10. https://doi.org/10.1093/postmj/qgac003 |
| [23] | Özel, M., Altıntaş, M. and Tatlıparmak, A.C. (2023) Predictors of One-Year Mortality Following Hip Fracture Surgery in Elderly. PeerJ, 11, e16008. https://doi.org/10.7717/peerj.16008 |
| [24] | Sakai, Y., Wakao, N., Matsui, H., Watanabe, T., Iida, H. and Katsumi, A. (2021) Elevated Red Blood Cell Distribution Width Is Associated with Poor Outcome in Osteoporotic Vertebral Fracture. Journal of Bone and Mineral Metabolism, 39, 1048-1057. https://doi.org/10.1007/s00774-021-01242-1 |
| [25] | Zhou, Y., Wang, J., Wang, X., Song, S., Bai, Y., Li, J., et al. (2023) A Prediction Model of Elderly Hip Fracture Mortality Including Preoperative Red Cell Distribution Width Constructed Based on the Random Survival Forest (RSF) and Cox Risk Ratio Regression. Osteoporosis International, 35, 613-623. https://doi.org/10.1007/s00198-023-06988-0 |
| [26] | Laulund, A.S., Lauritzen, J.B., Duus, B.R., Mosfeldt, M. and Jørgensen, H.L. (2012) Routine Blood Tests as Predictors of Mortality in Hip Fracture Patients. Injury, 43, 1014-1020. https://doi.org/10.1016/j.injury.2011.12.008 |
| [27] | Yin, P., Lv, H., Zhang, L., Long, A., Zhang, L. and Tang, P. (2016) Combination of Red Cell Distribution Width and American Society of Anesthesiologists Score for Hip Fracture Mortality Prediction. Osteoporosis International, 27, 2077-2087. https://doi.org/10.1007/s00198-015-3357-x |
| [28] | Aali-rezaie, A., Alijanipour, P., Shohat, N., Vahedi, H., Foltz, C. and Parvizi, J. (2018) Red Cell Distribution Width: An Unacknowledged Predictor of Mortality and Adverse Outcomes Following Revision Arthroplasty. The Journal of Arthroplasty, 33, 3514-3519. https://doi.org/10.1016/j.arth.2018.06.035 |
| [29] | Mahmoodpoor, A., Yousefi, B., Ghamari, A.A., Soleimanpour, H. and Karimian, A. (2019) Red Cell Distribution Width as a Novel Prognostic Marker in Multiple Clinical Studies. Indian Journal of Critical Care Medicine, 24, 49-54. https://doi.org/10.5005/jp-journals-10071-23328 |
| [30] | Liu, S., Zhang, H., Zhu, P., Chen, S. and Lan, Z. (2024) Predictive Role of Red Blood Cell Distribution Width and Hemoglobin-to-Red Blood Cell Distribution Width Ratio for Mortality in Patients with COPD: Evidence from NHANES 1999-2018. BMC Pulmonary Medicine, 24, Article No. 413. https://doi.org/10.1186/s12890-024-03229-w |
| [31] | Osawa, Y., Tanaka, T., Semba, R.D., Fantoni, G., Moaddel, R., Candia, J., et al. (2022) Proteins in the Pathway from High Red Blood Cell Width Distribution to All-Cause Mortality. eBioMedicine, 76, Article ID: 103816. https://doi.org/10.1016/j.ebiom.2022.103816 |
| [32] | Pepe, J., Colangelo, L., De Martino, V., Occhiuto, M., Iervolino, D., Pasqualetti, P., et al. (2023) Study of the Link between Hemotopoietic and Skeletal Systems in Patients Attending a Referral Center for Osteoporosis. Journal of Endocrinological Investigation, 46, 2391-2397. https://doi.org/10.1007/s40618-023-02095-3 |
| [33] | Thisayakorn, P., Tangwongchai, S., Tantavisut, S., Thipakorn, Y., Sukhanonsawat, S., Wongwarawipat, T., et al. (2021) Immune, Blood Cell, and Blood Gas Biomarkers of Delirium in Elderly Individuals with Hip Fracture Surgery. Dementia and Geriatric Cognitive Disorders, 50, 161-169. https://doi.org/10.1159/000517510 |
| [34] | Clark, D., Nakamura, M., Miclau, T. and Marcucio, R. (2017) Effects of Aging on Fracture Healing. Current Osteoporosis Reports, 15, 601-608. https://doi.org/10.1007/s11914-017-0413-9 |
| [35] | Akcal, M. and Eke, I. (2021) Post-Operative Red Cell Distribution Width Increase May Predict Mortality in Patients Operated for Hip Fracture. Clinical Laboratory, 67, 2568. https://doi.org/10.7754/clin.lab.2021.210337 |
