Goyal Hemant, Awad Hamza, Hu Zhi-De
Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA.
Department of Laboratory Medicine, the General Hospital of Jinan Military Region of PLA, Jinan 250031, China.
Ann Transl Med. 2017 Sep;5(17):342. doi: 10.21037/atm.2017.06.61.
Red blood cell distribution width (RDW) has been proved to be a strong prognostic marker in various diseases such as cardiovascular diseases, renal failure, viral hepatitis etc. But its prognostic value in acute pancreatitis (AP) remains controversial. The aim of this systematic review is to determine the prognostic value of RDW in AP.
PubMed, Cochrane, Google scholar, and Web of Science were searched on March 2, 2017 to identify studies that investigated the association between RDW and the prognosis of AP. The eligible studies were reviewed and summarized.
In total, 2008 articles were screened. Seven studies were included in the final analysis. Five studies estimated the prognostic value of RDW using receiver operating characteristic (ROC) curve analysis, and multivariable analysis was performed in only four studies. The major design weaknesses of eligible studies are their retrospective design and some of potential confounding factors were not adjusted.
Current evidence and findings support that high admission RDW can be used as a biomarker to identify the AP patients who are at high risk of mortality. However, due to the weaknesses of available studies, further well-designed studies with large sample size and various outcome endpoints are needed to rigorously evaluate the prognostic value of RDW in AP.
红细胞分布宽度（RDW）已被证明是心血管疾病、肾衰竭、病毒性肝炎等多种疾病的有力预后标志物。但其在急性胰腺炎（AP）中的预后价值仍存在争议。本系统评价的目的是确定RDW在AP中的预后价值。
于2017年3月2日检索了PubMed、Cochrane、谷歌学术和科学网，以确定研究RDW与AP预后之间关联的研究。对符合条件的研究进行了综述和总结。
共筛选出2008篇文章。最终分析纳入了7项研究。5项研究使用受试者工作特征（ROC）曲线分析评估RDW的预后价值，仅4项研究进行了多变量分析。符合条件的研究的主要设计缺陷是其回顾性设计，且一些潜在的混杂因素未得到调整。
目前的证据和研究结果支持，入院时高RDW可作为一种生物标志物，用于识别有高死亡风险的AP患者。然而，由于现有研究存在缺陷，需要进一步开展设计良好、样本量大且有各种结局终点的研究，以严格评估RDW在AP中的预后价值。
