入院红细胞体积分布宽度与老年髋部骨折术后肺部感染的关系及其预测价值  

The predictive value of red cell distribution width for postoperative lung infection in elderly patients with hip fracture

作　　者：张玉[1,2] 孙炜 孙维超[3] 姜骆永 阳世伟 ZHANG Yu;SUN Wei;SUN Weichao;JIANG Luoyong;YANG Shiwei(Clinical College of the Second Shenzhen Hospital,Anhui Medical University,Shenzhen 518035,China;Teaching Office,the First Affiliated Hospital of Shenzhen University(Shenzhen Second People's Hospital Shenzhen);Department of Orthopaedics,the First Affiliated Hospital of Shenzhen University(Shenzhen Second People's Hospital))

机构地区：[1]安徽医科大学深圳二院临床学院,518035 [2]深圳大学第一附属医院(深圳市第二人民医院)教学办 [3]深圳大学第一附属医院(深圳市第二人民医院)骨科

出　　处：《天津医药》2022年第6期608-612,共5页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(82003126);广东省医学科研基金资助项目(A2021321);深圳市科技计划项目(YCYJ20190806170418445)。

摘　　要：目的探讨老年髋部骨折患者入院时的红细胞体积分布宽度(RDW)与其髋部骨折术后肺部感染的关系及其预测价值。方法选取老年髋部骨折患者1341例,收集患者的年龄、性别、骨折类型、术中情况等临床资料以及血红蛋白、血清白蛋白和RDW等实验室指标。利用受试者工作特征(ROC)曲线确定RDW的最佳截断值,将患者分为低RDW组和高RDW组,并分析RDW水平与术后肺部感染的关系及其预测价值。结果老年髋部骨折术后肺部感染的发生率为5.89%,术后肺部感染患者的RDW水平明显高于无感染患者。ROC曲线显示,RDW预测术后肺部感染发生风险的曲线下面积为0.638(95%CI:0.576~0.700,P<0.01),RDW的最佳截断值为13.1%,敏感度为69.6%,特异度为55.9%,以此将患者分为低RDW组(RDW≤13.1%,758例)和高RDW组(RDW>13.1%,583例)。与低RDW组患者相比,高RDW组患者术后肺部感染的发生率更高(3.4%vs.9.1%,P<0.05)。多因素Logistic回归分析显示,RDW>13.1%是老年髋部骨折患者发生术后肺部感染的独立危险因素(OR=2.191,95%CI:1.311~3.661,P<0.05)。结论高RDW水平是老年髋部骨折术后肺部感染的独立危险因素,RDW对老年髋部骨折术后肺部感染有一定的预测价值。Objective To investigate the predictive value of red cell distribution width(RDW)of postoperative lunginfection in elderly patients with hip fracture.Methods Clinical data including age,gender,fracture information,intraoperative information and hemoglobin,albumin and RDW of a total of 1341 elderly patients with hip fracture werecollected.The receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of RDW.Patients were divided into the low RDW group and the high RDW group.The relationship between RDW and postoperativepulmonary infection and the predictive value of RDW were analyzed.Results The incidence of postoperative lunginfections was 5.89%in elderly patients with hip fracture.The RDW level of patients with postoperative lung infections wassignificantly higher than that of patients without postoperative lung infections.ROC curve showed that RDW predicted therisk of postoperative pulmonary infection with 0.638 area under the curve(95%CI:0.576~0.700,P<0.01),thecorresponding optimal diagnostic threshold was 13.1%,the sensitivity was 69.6%,and the specificity was 55.9%.Patientswere divided into the low RDW group(RDW≤13.1%,n=758)and the high RDW group(RDW>13.1%,n=583).Comparedwith the low RDW group,there was a higher incidence of postoperative pulmonary infection in the high RDW group(3.4%vs.9.1%,P<0.05).Multivariate Logistic regression analysis demonstrated that RDW>13.1%was an independent risk factorfor postoperative lung infection in elderly patients with hip fracture(OR=2.191,95%CI:1.311-3.661,P<0.05).Conclusion High RDW level is an independent risk factor for postoperative lung infection in elderly hip fracture patients.The RDW value has predictive value for onset of postoperative pulmonary infection in elderly patients with hip fracture.

关 键 词：髋骨折 手术后并发症 术后肺部感染 红细胞体积分布宽度 老年人 

分 类 号：R683.3[医药卫生—骨科学]