Prognostic value of three inflammatory markers for mortality after hip fracture in the geriatric population

This prospective cross-sectional study investigated the prognostic value of red blood cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) for predicting mortality in older adults after hip fracture surgery. A total of 469 patients aged ≥ 60 years were enrolled and followed for one year after surgery at a single tertiary medical center. Preoperative RDW, NLR, and PLR levels were analyzed using receiver operating characteristic curves. RDW was the only marker significantly associated with 3-month mortality and showed borderline significance at 1 year, with optimal cutoff values of 15.05% and 13.65%, respectively. Subgroup analysis revealed that RDW demonstrated higher predictive accuracy for 1-month and 3-month mortality in patients aged 60-80 years (AUCs: 0.834 and 0.855, respectively), whereas no marker showed significance in patients older than 80. NLR and PLR did not significantly predict mortality at any time point. These findings suggest that RDW is a simple and potentially useful biomarker for early mortality risk stratification in geriatric patients undergoing hip fracture surgery, particularly among those aged 60-80 years. RDW may assist clinicians in identifying high-risk individuals for closer postoperative monitoring.