天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (6): 608-612.doi: 10.11958/20212647

• 临床研究 • 上一篇    下一篇

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

张玉1，2，孙炜3，孙维超3，姜骆永3，阳世伟1，2△   

  1. 1安徽医科大学深圳二院临床学院（邮编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
  • 收稿日期:2021-11-29 修回日期:2022-02-12 出版日期:2022-06-15 发布日期:2023-12-20
  • 通讯作者: 阳世伟 E-mail:1063993905@qq.com
  • 基金资助:
    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）

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

ZHANG Yu1, 2, SUN Wei3, SUN Weichao3, JIANG Luoyong3, YANG Shiwei1, 2△   

  1. 1 Clinical College of the Second Shenzhen Hospital, Anhui Medical University, Shenzhen 518035, China; 2 Teaching Office, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital Shenzhen); 3 Department of Orthopaedics, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital)
  • Received:2021-11-29 Revised:2022-02-12 Published:2022-06-15 Online:2023-12-20

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摘要： 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1 341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。

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

Abstract: Abstract: Objective　To investigate the predictive value of red cell distribution width (RDW) of postoperative lung infection 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 1 341 elderly patients with hip fracture were collected. 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 postoperative pulmonary infection and the predictive value of RDW were analyzed. Results　The incidence of postoperative lung infections was 5.89% in elderly patients with hip fracture. The RDW level of patients with postoperative lung infections was significantly higher than that of patients without postoperative lung infections. ROC curve showed that RDW predicted the risk of postoperative pulmonary infection with 0.638 area under the curve (95%CI: 0.576~0.700，P＜0.01), the corresponding optimal diagnostic threshold was 13.1%, the sensitivity was 69.6%, and the specificity was 55.9%. Patients were divided into the low RDW group (RDW≤13.1%, n=758) and the high RDW group (RDW＞13.1%, n=583). Compared with 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 factor for 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.

Key words: hip fractures, postoperative complications, postoperative lung infections, red cell distribution width, aged