The Predictive Value Of Full Blood Count In Short-term Mortality Of Brittle Hip Fracture

Objective: To study the predictive value of full blood count in short-term mortality of brittle hip fracture.Methods: The clinical data including full blood count, comorbidities, 6-months mortality and 1-year mortality were from 231 patients admitted with brittle hip fracture from 2010 to 2012 and followed ≥one years. According to the age, the patients were divided into ≤60、60-70、70-80、80-90 and >90. Comparing the follow-up outcome of each age group as well as the correlation of age and full blood count. Comparing the follow-up outcome of male and female group. According to the quantity of comorbidities, the patients were divided into combined one kind of comorbidity or less and the two or more comorbidities, Comparing 6-months mortality, 1-year mortality and the differences of full blood count between two groups. The patients were divided into death and survival groups according to the result of 6-months and 1-year follow-up. The full blood count were compared between death and survival groups. The optimal cut-off levels of Hb, RBC and RDW were identified with ROC curves. The survival rates were compared with Kaplan-Meier curves.Results: The mean Hb was 113.10±18.07 g/L, the mean RBC was 3.79±0.59 x1012 / L, the mean RDW was 13.60±1.09%. The 6-months mortality and 1-year mortality was rising with age. The Hb, RBC, HCT were negatively related with age, while the RDW was positively correlated with age. The mean age of male was 73.2±11.0, female was 79.0±9.9. In 6-months followed up, the mortality of male was 19.54%, female was 9.72%.In 1-year followed up, the mortality of male was 20.69%, female was 13.19%. The 6-months mortality of male was significantly higher than female. For 6-months and 1-year follow-up, the mortality of patients combined one kind of comorbidity or less were 5.98%, 5.98%, while 21.05%, 26.32% for patients combined two or more comorbidities..In 6-month follow-up, the mean Hb of death and survival groups were(105.13±23.49)g/L、(114.36±16.86)g/L; the mean RBC were(3.50±0.78)x10^12/L、(3.84±0.54)x10^12/L; the mean RDW were(14.02±1.30)% 、(13.51±1.03)%, respectively. In 1-year follow-up, the mean Hb of death and survival groups were(106.00±23.05)g/L、(114.49±16.72)g/L; the mean RBC were(3.52±0.77)x10^12/L、(3.85±0.53)x10^12/L; the mean RDW were(14.17±1.32)% 、(13.51±1.03)%, respectively. According to the ROC curve, the cut-off values of Hb, RBC, RDW were 92.50 g/L, 3.245 x10^12/L, 13.55%, respectively. Kaplan-Meier curves showed that survival rates were significantly worse in patients with a Hb of ≤92.50 g/L(p<0.001, log-rank test) or a RBC level<3.245 X10^12/L(p<0.001, log-rank test)or a RDW level of >13.55%(p<0.005, log-rank test), based on the threshold levels of ROC curves. Multiple logistic regression analysis showed that Hb and RDW were the independent risk factors of short-term mortality of brittle hip fracture.Conclusion: Hb、RBC and RDW on admission were the predictors of short-term mortality in brittle hip fracture.