Background: Deep vein thrombosis (DVT) is a devastating complication in geriatric patients before hip fracture surgery, and the predictive value of red cell distribution width (RDW) and high-density lipoprotein cholesterol (HDL-C) for DVTs after hip fracture remains to be established. This study aimed to assess the predictive value of RDW, HDL-C, and RDW-to-HDL-C ratio (RHR) in preoperative DVTs screening.
Methods: We retrospectively analyzed the data of geriatric patients (≥ 65 years old) admitted for hip fracture surgery between 2015 and 2020. The receiver operating characteristic (ROC) curve and related parameters were used to evaluate the predictive value of the biomarkers. Patients were divided into two groups according to the cutoff value of RHR, and propensity score matching (PSM) and subgroup analyses were performed to assess the true correlations between RHR and DVT.
Results: Among 2566 eligible patients included, we identified RDW with the area under ROC curve (AUC) of 0.532, cut-off value of 15.89, specificity of 88.2%, sensitivity of 18.2%, HDL-C with AUC of 0.574, cut-off value of 1.20, specificity of 55.6%, sensitivity of 59.3%, and RHR with AUC of 0.578, cut-off value of 13.45, specificity of 71.3%, sensitivity of 43.4%. RHR (> 13.45) was independently associated with 1.54-fold risk (95% CI: 1.11– 2.14, P=0.011) of DVTs among the post-PSM cohort. And compared with the counterparts, the relative risk of RHR associated with DVT was higher in the subgroups of aged 65– 79 years (1.61 vs 1.45), non-hypoproteinemia (2.70 vs 1.29), non-diabetic (1.58 vs 1.41), non-hypertension (2.40 vs 1.06), ASA score I-II (2.38 vs 1.04), and femoral neck fracture (1.70 vs 1.50).
Conclusion: RDW, HDL-C and RHR were valuable biomarkers in predicting preoperative DVTs in geriatric patients with hip fracture, and RHR would be more efficient in the subgroups of younger age, better medical condition or femoral neck fracture.



中文翻译：

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红细胞分布宽度与高密度脂蛋白胆固醇比（RHR）：老年髋部骨折患者术前深静脉血栓形成的有希望的新预测因子

背景：深静脉血栓形成（DVT）是老年患者髋部骨折手术前的严重并发症，红细胞分布宽度（RDW）和高密度脂蛋白胆固醇（HDL-C）对髋部骨折后深静脉血栓形成的预测价值仍有待研究。成立。本研究旨在评估 RDW、HDL-C 和 RDW 与 HDL-C 比值 (RHR) 在术前 DVT 筛查中的预测价值。
方法：我们回顾性分析了2015年至2020年间因髋部骨折手术入院的老年患者（≥65岁）的数据。采用受试者工作特征（ROC）曲线和相关参数评估生物标志物的预测价值。根据 RHR 的临界值将患者分为两组，并进行倾向评分匹配 (PSM) 和亚组分析以评估 RHR 和 DVT 之间的真实相关性。
结果：在纳入的 2566 名符合条件的患者中，我们确定了 RDW，ROC 曲线下面积 (AUC) 为 0.532，临界值为 15.89，特异性为 88.2%，敏感性为 18.2%，HDL-C 的 AUC 为 0.574，临界值为 1.20，特异性为 55.6%，敏感性为 59.3%，RHR 的 AUC 为 0.578，截止值为 13.45，特异性为 71.3%，敏感性为 43.4%。RHR (> 13.45) 与 PSM 后队列中 DVT 的 1.54 倍风险 (95% CI: 1.11–2.14, P=0.011) 独立相关。与同行相比，65-79 岁（1.61 vs 1.45）、非低蛋白血症（2.70 vs 1.29）、非糖尿病（1.58 vs 1.41）、非-高血压（2.40 vs 1.06），ASA评分I-II（2.38 vs 1.04）和股骨颈骨折（1.70 vs 1.50）。
结论：RDW、HDL-C 和 RHR 是预测老年髋部骨折患者术前 DVT 的有价值的生物标志物，RHR 在年龄较小、身体状况较好或股骨颈骨折的亚组中更有效。