Prediction of Mortality and Morbidity After Hip Fracture Using Monocyte Distribution Width (MDW) (MDW)

January 10, 2026 updated by: EFSTATHIOS CHRONOPOULOS, National and Kapodistrian University of Athens

The Role of Monocyte Distribution Width (MDW) and Other Inflammatory Biomarkers in the Prediction of Mortality and Morbidity in Patients With Hip Fracture

Hip fracture is a common injury in older adults and is often associated with serious complications, longer hospital stays, and increased risk of death. One of the most important causes of poor outcomes after hip fracture surgery is infection, including severe infections such as sepsis. Early identification of patients at higher risk for complications could help improve treatment and survival.

This study aims to examine whether a blood test parameter called Monocyte Distribution Width (MDW), along with other commonly used inflammatory markers, can help predict complications and survival in elderly patients with hip fracture. MDW is measured as part of a routine complete blood count and has shown promise in the early detection of infection and systemic inflammation.

Approximately 100 patients aged 65 years or older who are admitted to the hospital with a low-energy hip fracture will be included in this study. Blood tests will be performed at hospital admission, after surgery, and at other time points as part of standard clinical care. These tests include routine blood counts and inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), antithrombin III, and MDW. No additional invasive procedures are required beyond standard medical care.

Researchers will collect information about each patient's medical history, overall health status, and daily activity level before the fracture. Patients will be followed after surgery to assess complications, length of hospital stay, and survival at 1 month, 3 months, and 1 year.

The results of this study may help determine whether MDW can be used as a simple and reliable marker to identify patients at higher risk of complications or death after hip fracture. This could support earlier intervention, closer monitoring, and improved care for elderly patients with hip fractures in the future.

Study Overview

Status

Recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Efstathios Chronopoulos
  • Phone Number: 00306944837793
  • Email: stathi24@yahoo.gr

Study Contact Backup

Study Locations

  • Greece
    • Attica
      • Kifissia, Attica, Greece, 14561
        • Recruiting
        • Laboratory for Research of the Musculoskeletal System
        • Contact:
          • Efstathios Chronopoulos, Prof.
          • Phone Number: 00306944837793
          • Email: stathi24@yahoo.gr
        • Sub-Investigator:
          • Kalliopi Lampropoulou-Adamidou
        • Contact:
        • Principal Investigator:
          • Efstathios Chronopoulos
        • Sub-Investigator:
          • Lamprini Agapitou

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population includes approximately 100 geriatric patients aged 65 years and older admitted with low-energy hip fractures and treated surgically at the 2nd Orthopaedic Department of the General Hospital of Attica KAT. Participants undergo routine perioperative evaluation, including demographic and clinical data collection and laboratory assessment of inflammatory biomarkers such as monocyte distribution width (MDW), C-reactive protein, procalcitonin, and antithrombin III. Patients are followed prospectively to evaluate postoperative morbidity and all-cause mortality at 1 month, 3 months, and 12 months following surgery.

Description

Inclusion Criteria:

  • Patients aged ≥65 years
  • Admission with low-energy hip fracture (femoral neck, intertrochanteric, or subtrochanteric fracture)
  • Admission to General Hospital of Attica KAT
  • Availability of baseline laboratory measurements, including complete blood count with monocyte distribution width (MDW) and inflammatory biomarkers

Exclusion Criteria:

  • Age <65 years
  • High-energy trauma-related hip fractures
  • Pathological fractures

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Geriatric Patients With Hip Fracture

This cohort consists of patients aged 65 years or older who are admitted with a low-energy hip fracture and undergo surgical treatment. All participants receive standard-of-care clinical management according to institutional protocols. No experimental interventions are assigned as part of this study.

Clinical data, medical history, and pre-fracture functional status are recorded at baseline. Blood samples are collected as part of routine care at hospital admission, postoperatively, and at discharge to measure complete blood count parameters, including Monocyte Distribution Width (MDW), and other inflammatory markers such as C-reactive protein, procalcitonin, and antithrombin III.

Participants are followed postoperatively to assess clinical outcomes, including complications, morbidity, mortality, and health-related quality of life. Comparisons will be performed between subgroups defined by clinical outcomes or biomarker levels.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
All-cause mortality
Time Frame: Up to 12 months postoperatively.
Assessment of all-cause mortality in geriatric patients with low-energy hip fracture and its association with Monocyte Distribution Width (MDW) values measured at admission and during hospitalization.
Up to 12 months postoperatively.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative morbidity
Time Frame: From postoperative day 1 through study completion, an average of 1 year.
Assessment of postoperative morbidity, including infectious and non-infectious complications, and its association with Monocyte Distribution Width (MDW) and other inflammatory markers (C-reactive protein, procalcitonin, antithrombin III).
From postoperative day 1 through study completion, an average of 1 year.
Incidence of sepsis
Time Frame: From postoperative day 1 through study completion, an average of 1 year.
Occurrence of sepsis during hospitalization or postoperative follow-up, evaluated in relation to MDW values and other inflammatory biomarkers.
From postoperative day 1 through study completion, an average of 1 year.
Change in Monocyte Distribution Width (MDW) over time
Time Frame: From hospital admission through hospital discharge, up to 14 days postoperatively.
Evaluation of changes in MDW values from admission through the postoperative period and at discharge, and their association with clinical outcomes.
From hospital admission through hospital discharge, up to 14 days postoperatively.
Length of hospital stay
Time Frame: From the date of hospital admission until hospital discharge, assessed up to 30 days.
Duration of hospitalization measured in days and its association with MDW and inflammatory marker levels.
From the date of hospital admission until hospital discharge, assessed up to 30 days.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National and Kapodistrian University of Athens

Investigators

  • Study Director: Efstathios Chronopoulos, KAT General Hospital, Athens Greece

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2024

Primary Completion (Estimated)

March 1, 2026

Study Completion (Estimated)

March 1, 2026

Study Registration Dates

First Submitted

December 21, 2025

First Submitted That Met QC Criteria

January 10, 2026

First Posted (Actual)

January 20, 2026

Study Record Updates

Last Update Posted (Actual)

January 20, 2026

Last Update Submitted That Met QC Criteria

January 10, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 5570/04-03-2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will be made available to qualified researchers upon reasonable request. Data sharing will comply with the General Data Protection Regulation (EU GDPR) and applicable ethical and institutional requirements. Requests must include a brief description of the intended research use. Approved requests will be granted access to fully anonymized data sets, ensuring that study participants cannot be identified.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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