One condition, different environments? Haematologic parameter dynamics and pulmonary embolism in urban vs. rural...

Pulmonary embolism (PE) remains a major cause of morbidity and mortality among orthopaedic patients. Despite documented cardiovascular disparities between urban and rural populations, data linking these environments with PE incidence and haematologic changes are scarce. The study investigates the differences in acute pulmonary embolism (APE) incidence and dynamic haematologic changes between urban and rural orthopaedic patients.

A retrospective analysis included 276 orthopaedic patients hospitalized over eight years in a tertiary centre in Eastern Poland. Patients were categorized by residence (urban vs. rural). Complete blood count parameters, notably red cell distribution width (RDW), platelet indices, and erythrocyte parameters, were analyzed on admission and at clinical suspicion of APE. APE was confirmed by computed tomography pulmonary angiography. Ethical approval was obtained (KE-0254/17/2019). Standard statistical tests were used (p<0.05).

APE incidence did not differ significantly between urban (39.1%) and rural (47.4%) patients (p=0.181). However, urban patients had significantly higher RDW values on admission (p=0.037). Additionally, females showed significantly elevated RDW, particularly in rural settings (p=0.038). Other haematologic parameters showed no significant differences between groups.

Although residence did not significantly influence APE incidence, the elevated RDW in urban patients suggests environmental or lifestyle-related haematologic modulation. Considering the limited similar studies in the literature, RDW emerges as a potential, cost-effective biomarker for early APE risk stratification in orthopaedic patients.