Correlation between red blood cell distribution width and deep vein thrombosis in patients with lower limb fractures.

OBJECTIVE: This study aimed to investigate the relationship between red blood cell distribution width (RDW) and perioperative lower-extremity deep vein thrombosis (DVT) in patients aged 18-75 years with lower-limb fractures. MATERIAL AND METHODS: From February 2021 to February 2023, we included 766 patients aged 18-75 years with lower-limb fractures. Univariate and multivariable analyses were used to investigate the association between RDW and DVT. The discriminatory ability and cohort-specific exploratory cut-off values of RDW were evaluated using receiver operating characteristic (ROC) curves. RESULTS: ROC curve analysis identified cohort-specific exploratory cut-off values of 43.9 fL for RDW standard deviation (RDW-SD) and 13.2% for RDW coefficient of variation (RDW-CV), and RDW-SD showed better discrimination than RDW-CV (P < 0.05). In the adjusted analyses, RDW-SD ≥43.9 fL [adjusted odds ratio (aOR), 3.372; P < 0.001], RDW-CV ≥13.2% (aOR, 2.556; P < 0.001), advanced age (aOR, 1.054; P < 0.001), higher platelet count (PLT; per 10 × 10⁹/L increase: aOR, 1.115; P = 0.010), and Hb <120 g/L (aOR, 1.785; P < 0.001) were independently associated with perioperative DVT. Significant differences in age, fracture site, DVT, diabetes, cancer, and Hb <120 g/L were observed between the RDW-SD ≥43.9 fL and RDW-SD <43.9 fL groups (all P < 0.05). CONCLUSION: Advanced age, Hb <120 g/L, higher PLT, RDW-SD ≥43.9 fL, and RDW-CV ≥13.2% were independently associated with perioperative DVT in patients aged 18-75 years with lower-limb fractures. RDW-SD showed better discrimination than RDW-CV.