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

Date Published: 2026-07-31

Abstract:
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. 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. 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?×?10?/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). 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.

Introduction:
Deep vein thrombosis (DVT) is a common and serious perioperative complication of lower extremity fractures, especially during trauma and surgical interventions, and its incidence is significantly increased, which may lead to pulmonary embolism (PE), long-term dysfunction, and even death. In orthopaedic surgery, patients with lower limb fractures are at a significantly higher risk of DVT due to immobilization and surgical trauma. Despite the widespread use of preventive measures, the incidence of perioperative DVT…

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