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Elevated red blood cell distribution width is associated with poor outcome in osteoporotic vertebral fracture

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Abstract

Introduction

Red blood cell distribution width (RDW) has been evaluated as a potential screening marker for cancer and prognostic marker in heart failure and coronary heart disease. Recent studies have been suggested the association of RDW with mortality in patients with hip fracture and arthroplasty. Objective of this study was to investigate whether RDW as a prognostic marker is significant in patients with osteoporotic vertebral fracture (OVF).

Materials and methods

Total of 460 patients with fresh OVF from January 2014 and September 2017 were assessed for a 1-year follow-up period. The cutoff value for RDW was set at 15%, and outcomes of conservative treatment of OVF were evaluated using the Japanese Orthopaedic Association (JOA) scores, Barthel index, and walking state.

Results

Of the total 460 patients, 125 patients (27.2%) had an elevated RDW. RDW value was not correlated with osteoporotic parameters. Both JOA score and Barthel index were significantly lower at 1 year after treatment in the elevated RDW group. In the elevated RDW group, 21 patients died within 1 year (mortality 16.8%) compared with 7 patients (mortality 2.1%) in the non-elevated RDW group; this was statistically significant. Multivariate statistical analysis showed elevated RDW, independent walk before OVF and skeletal muscle mass index (SMI) remained independent factors associated with abasia after OVF affected.

Conclusion

Elevated RDW was associated with the poor clinical outcomes of conservative treatment of an OVF, independent of osteoporosis or severity of the OVF. RDW provides prognostic information for risk stratification as a senescence biomarker.

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Funding

This research did not receive any specific grant from funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, 35 Gengo, Obu, Aichi, Japan

    Yoshihito Sakai, Norimitsu Wakao, Hiroki Matsui, Tsuyoshi Watanabe & Hiroki Iida

  2. Department of Hematology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan

    Akira Katsumi

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  1. Yoshihito Sakai
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  2. Norimitsu Wakao
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  3. Hiroki Matsui
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  4. Tsuyoshi Watanabe
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Correspondence to Yoshihito Sakai.

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Conflict of interest

Yoshihito Sakai, Norimitsu Wakao, Hiroki Matsui, Keisuke Tomita, Tsuyoshi Watanabe, Hiroki Iida, and Akira Katsumi declare that they have no conflict of interest.

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All procedures involving human participants were in accordance with the ethical standards of the institutional and national research committees (Reference Number: No 1102) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Sakai, Y., Wakao, N., Matsui, H. et al. Elevated red blood cell distribution width is associated with poor outcome in osteoporotic vertebral fracture. J Bone Miner Metab 39, 1048–1057 (2021). https://doi.org/10.1007/s00774-021-01242-1

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