{"title":"Red blood cell distribution width as a predictor of mortality in critically ill pediatric patients: a systematic review and meta-analysis.","authors":"Yinhong Yu, Xiaomei Hu, Yaping Shen","doi":"10.3389/fped.2025.1646179","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Red blood cell distribution width (RDW) has been found to predict outcomes in critically ill adult patients. However, its utility in pediatric patients remains unexplored. We reviewed published evidence and conducted a meta-analysis to assess whether RDW can be used to predict mortality in the pediatric intensive care unit (PICU).</p><p><strong>Methods: </strong>All observational studies assessing the association between RDW and PICU mortality available on the databases of PubMed, Embase, Scopus, and Web of Science up to 4th November 2024 were included. A detailed review of study outcomes was conducted with a meta-analysis.</p><p><strong>Results: </strong>Seven studies were included. 6,327 pediatric patients were included in these studies. On qualitative analysis, five of the seven studies found a statistically significant association between high RDW and PICU mortality. Four studies used RDW as a continuous variable, while three studies reported specific RDW cut-offs. Meta-analysis showed that an incremental increase in RDW was associated with a statistically significant increased risk of mortality (OR: 1.24 95% CI: 1.07, 1.44 I<sup>2</sup> = 32%). Pooled analysis of studies using RDW as a categorical variable showed that higher values of RDW were associated with significantly higher risk of mortality (OR: 1.73 95% CI: 1.02, 2.92 I<sup>2</sup> = 77%).</p><p><strong>Conclusions: </strong>RDW could be a potential predictor of mortality in the PICU. Results need to be interpreted with caution owing to the limited number of studies with variable study populations. Additional studies are needed to strengthen evidence.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD42024606208).</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1646179"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477246/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1646179","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Red blood cell distribution width (RDW) has been found to predict outcomes in critically ill adult patients. However, its utility in pediatric patients remains unexplored. We reviewed published evidence and conducted a meta-analysis to assess whether RDW can be used to predict mortality in the pediatric intensive care unit (PICU).
Methods: All observational studies assessing the association between RDW and PICU mortality available on the databases of PubMed, Embase, Scopus, and Web of Science up to 4th November 2024 were included. A detailed review of study outcomes was conducted with a meta-analysis.
Results: Seven studies were included. 6,327 pediatric patients were included in these studies. On qualitative analysis, five of the seven studies found a statistically significant association between high RDW and PICU mortality. Four studies used RDW as a continuous variable, while three studies reported specific RDW cut-offs. Meta-analysis showed that an incremental increase in RDW was associated with a statistically significant increased risk of mortality (OR: 1.24 95% CI: 1.07, 1.44 I2 = 32%). Pooled analysis of studies using RDW as a categorical variable showed that higher values of RDW were associated with significantly higher risk of mortality (OR: 1.73 95% CI: 1.02, 2.92 I2 = 77%).
Conclusions: RDW could be a potential predictor of mortality in the PICU. Results need to be interpreted with caution owing to the limited number of studies with variable study populations. Additional studies are needed to strengthen evidence.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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