Hepatobiliary Pancreatic Surgery Department, Affiliated Huadu Hospital, Southern Medical University, Guangzhou, China.
Front Immunol. 2022 Oct 17;13:997853. doi: 10.3389/fimmu.2022.997853. eCollection 2022.
Red blood cell distribution width (RDW) is a common biomarker of bacterial infections, and it can be easily obtained from a routine blood test. We investigate the diagnostic value of RDW for the prediction of mortality in adult sepsis patients through a review and meta-analysis. We registered this review in PROSPERO (Registration Number: CRD42022357712), and the details of the registration are included in Appendix 1.
We searched PubMed, Cochrane Library, Springer, and Embase between Jan. 1, 2000, and May 30, 2022, for primary studies about this research. We collected articles that investigated RDW for varying degrees of sepsis patients-those who suffered from sepsis, severe sepsis, or sepsis shock. Studies of healthy people and sepsis of children and neonates were excluded from our research. The definition of study characteristics and data extraction were finished by two independent researchers and discrepancies resolved by consensus. The combined sensitivities and specificities were calculated by meta-analysis using STATA14.0. The sensitivity of the included studies was analyzed by excluding studies that had potential heterogeneity. A summary operating characteristic curve was made to evaluate the diagnostic value for the prediction of mortality in adult sepsis patients. The Fagan test was used to explore likelihood ratios and posttest probabilities. Finally, we investigated the source of heterogeneity using meta-regression.
Twenty-four studies, including 40,763 cases altogether, were included in this analysis. Bivariate analysis indicated a combined sensitivity of 0.81 (95% CI 0.73-0.86) and specificity of 0.65 (95% CI 0.54-0.75). The area under the summary receiver operating characteristic curve was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity resided in the studies ( 96.68, 95% CI 95.95-97.4). Meta-regression showed that the reference description, prospective design, and blinded interpretation of the included studies could be responsible for the heterogeneity.
RWD is an available and valuable biomarker for prediction of mortality in adult sepsis patients.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022357712.
红细胞分布宽度（RDW）是细菌感染的常见生物标志物，可从常规血液检查中轻松获得。我们通过综述和荟萃分析研究了 RDW 对成人脓毒症患者死亡率预测的诊断价值。我们在 PROSPERO（注册号：CRD42022357712）中对该综述进行了注册，注册详情见附录 1。
我们于 2000 年 1 月 1 日至 2022 年 5 月 30 日期间在 PubMed、Cochrane Library、Springer 和 Embase 上检索了有关这项研究的原始研究。我们收集了研究 RDW 对不同程度脓毒症患者的文章，这些患者患有脓毒症、严重脓毒症或脓毒症休克。本研究排除了健康人群和儿童及新生儿脓毒症的研究。通过两位独立研究人员完成研究特征和数据提取的定义，并通过共识解决差异。使用 STATA14.0 通过荟萃分析计算合并敏感性和特异性。通过排除具有潜在异质性的研究来分析纳入研究的敏感性。制作综合受试者工作特征曲线以评估 RDW 对成人脓毒症患者死亡率预测的诊断价值。使用 Fagan 检验探讨似然比和后测概率。最后，我们使用元回归来研究异质性的来源。
共纳入 24 项研究，共纳入 40763 例患者。二项分析表明，合并敏感性为 0.81（95%CI 0.73-0.86），特异性为 0.65（95%CI 0.54-0.75）。综合受试者工作特征曲线下面积为 0.81（95%CI 0.77-0.84）。研究中存在大量异质性（ 96.68，95%CI 95.95-97.4）。元回归表明，纳入研究的参考描述、前瞻性设计和盲法解释可能是导致异质性的原因。
RDW 是预测成人脓毒症患者死亡率的一种可用且有价值的生物标志物。
https://www.crd.york.ac.uk/PROSPERO/，标识符 CRD42022357712。
