Does Red Cell Distribution Width Predict Hip Fracture Mortality Among the Arab Population? A Single-Center Retrospective Cohort Study

Abstract

Background Hip fractures impose significant morbidity and mortality. Red cell distribution width (RDW) appears to be an emerging tool in predicting mortality following hip fractures. Several factors can influence the RDW value including genetic factors and ethnicity. The purpose of the study was to assess the relation between RDW level at admission and hip fracture mortality within 6 months among Arab/Middle East populations. Methods We conducted a single-center retrospective cohort study including 549 patients (274 female and 275 male) diagnosed with a hip fracture undergoing surgery from February 2016 to December 2019. All included patients shared the same country of origin which is Arab Middle East country. Statistical analysis, including binary regression, was performed to assess the relationship between RDW and mortality within 6 months of admission. Other predictors of mortality following hip fracture surgery were also assessed. Results The mean age was 76.42 (±9.19) years. Seventy (12.8%) of participants died within 6 months. No statistically significant association (P=0.053) between RDW level at admission and mortality within 6 months of surgery was found. Binary regression demonstrated that the only independent predictors of mortality were age (P= 0.003, odds ratio 1.048 with 95% CI 1.016 to 1.080) and male gender (P= 0.021, odds ratio 1.872 with 95% CI 1.100 to 3.185). Conclusion Although the previous studies reported that RDW is one of the predictors of mortality in hip fracture patients, our study found no relation in the Arab population. This finding may confirm the influence of genetic factors and ethnicity on RDW value. We recommend further large-scale multicenter studies to solidly establish the relationship between RDW and hip fracture mortality among the Arab/Middle East population.

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

“…After assessing for eligibility, 18 studies were excluded because they did not have full text ( n = 2), did not have mortality data ( n = 3), did not have RDW data ( n = 4), did not include our target population ( n = 3), did not assess our outcome of interest ( n = 1), involved letters to editors ( n = 2), had missing data ( n = 1), used an irrelevant study design or approach ( n = 1), or shared a database with another study that was included in the review ( n = 1). As a result, 10 studies remained to perform the meta-analysis [ 11 , 12 , 13 , 14 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

“…The 10 studies were conducted between 2013 and 2022 in Türkiye [ 31 , 33 , 34 , 36 ], Jordan [ 32 ], China [ 12 , 35 ], the United Kingdom [ 11 ], Israel [ 13 ], and Peru [ 14 ], involving a total of 5834 patients (2241 men and 3593 women) with a pooled mean age of 87.61 ± 3.21 years. These studies comprised four retrospective cohort studies [ 13 , 32 , 33 , 36 ], two retrospective case–control studies [ 31 , 34 ], three prospective cohort studies [ 11 , 12 , 35 ], and one retrospective and prospective cohort study [ 14 ]. Eight studies indicated that all patients included in their analyses underwent surgery after sustaining hip fractures [ 11 , 13 , 14 , 32 , 33 , 34 , 35 , 36 ], one study reported that 113 of 1479 patients received conservative treatment only [ 12 ], and one study did not provide any information regarding post-fracture interventions [ 31 ].…”

Characteristics of Elderly Hip Fracture Patients in Jordan: A Multicenter Epidemiological Study

“…It was also from single center but included patients over 3.5 years duration. 10 They reported a 12.8% mortality rate within 6 months of surgery. Our study is a multicenter study from 4 major hospitals covering about 50% of hip fracture care in Jordan.…”

“…There were only two single-center studies from Jordan that discussed hip fracture-related issues. 9 , 10 …”

“…There were only two single-center studies from Jordan that discussed hip fracturerelated issues. 9,10 Hip fractures can lead to significant morbidity and mortality in elderly patients. The 30-day and 1-year mortality can reach up to 10% and 30% respectively.…”