Work

Preoperative RDW-Based composite score for predicting mortality after hip fracture surgery

Year: 2026

Type: article

Abstract: INTRODUCTION: To develop a simple preoperative score based on age, red cell distribution width–standard deviation (RDW-SD), and the lactate-to-albumin ratio (LAR), and to evaluate its performance in predicting 3-month and 1-year mortality after femoral neck fracture treated with primary total hip arthroplasty. MATERIALS AND METHODS: In this single-center retrospective cohort, 666 consecutive patients who underwent hip fracture surgery between January 2020 and June 2024 were analyzed. The primary outcomes were 3-month and 1-year all-cause mortality. Preoperative demographic characteristics and laboratory parameters (RDW-SD, lactate, albumin, and neutrophil-to-lymphocyte ratio) were recorded. Candidate predictors were screened using univariable logistic regression, followed by a multivariable model including age, RDW-SD, and LAR. An integer risk score was derived from regression coefficients. RESULTS: Overall, 245 patients (36.8%) died within 1 year. Non-survivors were older and had higher RDW-SD, lactate, LAR, and neutrophil-to-lymphocyte ratio, and lower albumin levels than survivors (all p < 0.01). In multivariable analysis, age, RDW-SD, and LAR remained independent predictors and were combined into an age–RDW-SD–LAR score ranging from 0 to 12 points. When classified into three risk groups (0–3, 4–7, and 8–12), observed 1-year mortality rates were 10.7%, 35.6%, and 62.8%, respectively, closely matching model-predicted estimates. The score showed good discrimination for 1-year mortality (AUC 0.78; 95% CI 0.75–0.82) with similar performance after bootstrap internal validation. Albumin was expressed in g/L, and the lactate-to-albumin ratio was calculated accordingly. CONCLUSIONS: The age–RDW-SD–LAR score, based on routinely available preoperative laboratory measures, provides a simple and clinically applicable tool for estimating early and late mortality after femoral neck fracture treated with primary total hip arthroplasty and may support preoperative risk stratification, pending external validation.

Source: BMC Musculoskeletal Disorders

DOI: 10.1186/s12891-026-09578-3

Authors: Sevim Şenol Karataş, Sait Fatih Öner, Oğuz Kağan Bulut, Hacı Bayram Tosun

Institution: Sağlık Bilimleri Üniversitesi

Language: English

Topic: Hip and Femur Fractures

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090