Red cell distribution width as a predictor of mortality after hip fracture: a systematic review and meta-analysis

X.-F. Zhu, H.-Y. Weng, S.-F. Huang

Department of Orthopedics, First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang Province, China. zhu1305890@163.com

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• Orthopedics

OBJECTIVE: This review examined the association between red cell distribution width (RDW) and mortality after hip fracture.

MATERIALS AND METHODS: PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 10th January 2023 for studies comparing mortality after hip fracture based on RDW. All cut-offs of RDW were accepted. Crude and adjusted mortality ratios were pooled separately.

RESULTS: Nine studies with 5,274 patients were eligible. Meta-analysis of eight studies reporting crude mortality rates showed that patients with high RDW had a significantly higher risk of mortality than those with low RDW (RR: 2.81 95% CI: 2.05, 3.86 I2=82%). The results did not change in significance on subgroup analyses based on study location, sample size, the cut-off of RDW, and follow-up. Four studies reported adjusted mortality rates. Analysis of the same showed that high RDW was an independent predictor of mortality in hip fracture patients (HR: 3.14 95% CI: 1.38, 7.14 I2=95%).

CONCLUSIONS: Within the limitations of the review, RDW was found to be an indicator of mortality in hip fracture patients. High RDW was significantly associated with increased mortality despite different cut-offs among studies. Further research is needed to generate more rigorous evidence.

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