• Hung Wei-Hsiang, Yuqing Zhu, Jingyuan Zhang, and Yinwang Zhang.
• Department of Orthopedic Surgery, Zhongshan Hospital Xiamen Branch, Fudan University, Fujian, China.
• Int. J. Clin. Pract. 2021 Dec 1; 75 (12): e14791.

PurposeWe aimed to determine whether pretreatment red blood cell distribution width (RDW) is an efficient predictor of 30-day mortality in older patients undergoing hip fracture surgery.MethodsIn this prospective cohort study, 203 patients with hip fractures were eligible and followed up for at least 30 days. All the patients underwent medical examinations. RDW was measured using an automated hematology analyzer. To evaluate the prognostic significance of RDW, Cox proportional hazard model and Kaplan-Meier analyses were performed.ResultsOf the 203 patients (114 men, 89 women), 28 (13.79%) died within 30 days. The mean RDW was significantly higher in the deceased group than in the survival group (14.54% ± 1.09% vs 13.26% ± 0.57%; P < .001). Multivariate Cox regression analysis showed that elevated RDW (hazard ratio = 2.73, 95% confidence interval = 2.06-3.62, P < .001) was the key predictor of 30-day mortality in older patients undergoing hip fracture surgery. Survival analysis showed that patients with a high RDW had a significantly higher 30-day mortality rate (log-rank test, P < .05). Similar results were observed in the male and female subgroups.ConclusionRDW might be an effective predictor of 30-day mortality in older patients undergoing hip fracture surgery.© 2021 John Wiley & Sons Ltd.

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