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Review
. 2024 Mar 14;60(3):485.
doi: 10.3390/medicina60030485.

The Association between Red Blood Cell Distribution Width and Mortality Risk after Hip Fracture: A Meta-Analysis

Bao Tu Thai Nguyen  1   2 , Duy Nguyen Anh Tran  1   2 , Tan Thanh Nguyen  2 , Yi-Jie Kuo  3   4 , Yu-Pin Chen  3   4
Affiliations
Review

The Association between Red Blood Cell Distribution Width and Mortality Risk after Hip Fracture: A Meta-Analysis

Bao Tu Thai Nguyen et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Hip fractures in the elderly pose a considerable health risk and cause concern. Red blood cell distribution width (RDW) is a valuable marker for identifying patients at high risk of age-related mortality and various disorders and diseases. However, its association with poor patient outcomes following hip fractures has yet to be fully established. Hence, the purpose of this meta-analysis was to investigate and gain a better understanding of the relationship between RDW levels and the risk of mortality after hip fractures. Materials and Methods: PubMed, Embase, Web of Science, and other databases were comprehensively searched until April 2023 to identify relevant studies. The meta-analysis included observational studies finding the association between RDW at admission or preoperation and short-term and long-term mortality rates following hip fractures. The results were presented in terms of odds ratios (ORs) or hazard ratios (HRs) with corresponding 95% confidence intervals (CIs). Results: This meta-analysis included 10 studies involving 5834 patients with hip fractures. Patients with preoperative RDW of over 14.5% had higher risks of 1-year (OR: 5.40, 95% CI: 1.89-15.48, p = 0.002) and 3-month (OR: 2.91, 95% CI: 1.42-5.95, p = 0.004) mortality. Higher admission or preoperative RDW was significantly associated with an 11% higher mortality risk after 1 year (HR: 1.11, 95% CI: 1.06-1.17, p < 0.00001). Patients with higher preoperative RDW had a significantly higher risk of 6-month mortality, which was three times that of those with lower preoperative RDW (OR: 3.00, 95% CI: 1.60-5.61, p = 0.0006). Higher preoperative RDW was correlated to a higher 30-day mortality risk (OR: 6.44, 95% CI: 3.32-12.47, p < 0.00001). Conclusions: Greater RDW values at admission or before surgery were associated with a higher risk of short-term and long-term mortality following hip fractures. Because RDW can be easily measured using a routine blood test at a low cost, this parameter is promising as an indicator of mortality in elderly patients with hip fractures.

Keywords: bone healing; chronic inflammation; fragility; hip fracture; meta-analysis; mortality; oxidative stress; prognosis; red blood cell distribution width.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The study screening and selection process flow chart.
Figure 2
Figure 2
Forest plot of the association between RDW and 1-year mortality risk after hip fractures [13,33,34,36].
Figure 3
Figure 3
Forest plot of the association between RDW and 6-month mortality risk after hip fractures [13,14,32,36].
Figure 4
Figure 4
Forest plot of the association between RDW and 3-month mortality risk after hip fractures [13,34,36].
Figure 5
Figure 5
Forest plot of the association between RDW and 30-day mortality risk after hip fractures [35,36].
See this image and copyright information in PMC

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