title: Red cell distribution width is an independent predictor of mortality in hip fracture.
abstract: BACKGROUND
  the red cell distribution width (RDW), an automated measure of variability in the red blood cell size on full blood count (FBC) is an independent predictor of mortality in several disease states and in healthy older people.
  
  
  OBJECTIVE
  we wanted to determine the prognostic value of RDW in patients following a hip fracture-a condition associated with high mortality.
  
  
  METHODS
  we examined the relationship between admission RDW and mortality in 698 consecutive patients admitted with hip fracture.
  
  
  METHODS
  regression analysis was used to examine admission RDW and subsequent mortality, adjusting for admission haemoglobin, mean corpuscular volume, age, gender, pre-morbid residence and independence level, Charlson co-morbidity index and post-operative complications.
  
  
  RESULTS
  the mean age was 78 ± 13 years. Unadjusted 1-year mortality was 12, 15, 29 and 36% across quartiles of increasing RDW. Along with age and post-operative complications, RDW remained significantly associated with in-hospital, 120-day and 1-year mortality [adjusted hazard ratios: HR: 1.119, 95% CI: (1.000-1.253), P = 0.05, 1.134 (1.047-1.227), P = 0.004 and 1.131 (1.067-1.199), P < 0.001, respectively]. These relationships remained significant at all three time points on repeat analysis in non-anaemic patients (n = 548).
  
  
  CONCLUSIONS
  RDW, a widely available parameter on FBC, is independently associated with an increased risk of short- and long-term mortality following hip fracture.
authors.affiliation: Department of Ageing and Health,  St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH,  UK.
authors.forename: Upaasna
authors.initials: U
authors.lastname: Garbharran
authors.forename: Suchitra
authors.initials: S
authors.lastname: Chinthapalli
authors.forename: Iona
authors.initials: I
authors.lastname: Hopper
authors.forename: Marc
authors.initials: M
authors.lastname: George
authors.forename: Diane L
authors.initials: DL
authors.lastname: Back
authors.forename: Frances
authors.initials: F
authors.lastname: Dockery
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004909:Erythrocyte Indices; D005260:Female; D006620:Hip Fractures / Q000097:blood* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors