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J Pediatr Intensive Care
DOI: 10.1055/s-0041-1735876
Review Article

A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

Devin Murphy 
1   Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
,
Etan Orgel
2   Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Los Angeles, California, United Sates
3   Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, California, United Sates
,
Wouter Koek
1   Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
,
Melissa Frei-Jones
1   Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
4   Department of Pediatrics, Pediatric Hematology–Oncology, Long School of Medicine, University of Texas Health Science Center San Antonio, Texas, United Sates
,
Christopher Denton
2   Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Los Angeles, California, United Sates
3   Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, California, United Sates
,
Deepak Kamat
1   Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United Sates
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Abstract

Red cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.

Keywords

RDW - hematology - mortality - critical care - pediatric

Supplementary Material



Publication History

Received: 06 June 2021

Accepted: 11 August 2021

Article published online:
15 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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