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

A Retrospective Cohort Study: The Relationship between the Coefficient of Variation of Red Blood Cell Volume Size (RDW-CV) and All-Cause Mortality in Elderly Patients with Hip Fracture

摘要: 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。

Abstract: 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.