Cao Qing, He Xiafei, Chen Xiuhuang, Han Xing, Yang Lutao
Department of Burn Plastic and Wound Repair, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, No. 48 Taling Nanlu, Jiujiang, 332000, Jiangxi, China.
Eur J Med Res. 2024 Dec 18;29(1):589. doi: 10.1186/s40001-024-02165-z.
Red blood cell distribution width (RDW) is a marker of inflammation and oxidative stress, and its elevation has been associated with poor outcomes in critically ill patients. This meta-analysis aimed to evaluate the association between RDW at admission and short-term mortality in patients with severe burn injury.
We systematically searched PubMed, Embase, and Web of Science up to August 2024, following PRISMA 2020 and Cochrane guidelines. Cohort studies of adult severe burn patients who reported RDW at admission and short-term mortality were included. Meta-analyses were performed using random-effects models, with mean difference (MD) and relative risk (RR) calculated for RDW and mortality outcomes, respectively. Subgroup and sensitivity analyses were conducted to assess heterogeneity.
Nine cohort studies involving 5268 patients were included. Overall, RDW at admission was higher in nonsurvivors compared to survivors [MD: 0.95%, 95% confidence interval (CI): 0.52-1.38, p < 0.001, I = 57%]. In addition, a high RDW was associated with an increased risk of short-term mortality (RR: 1.76, 95% CI: 1.41-2.19, p < 0.001, I = 77%). Sensitivity analyses by excluding one dataset at a time confirmed the robustness of these findings. Subgroup analyses revealed no significant differences based on clinical settings, patient age, sex, follow-up duration, or study quality.
RDW at admission is a significant predictor of short-term mortality in patients with severe burn injury. This finding highlights the potential role of RDW as a simple and effective marker for risk stratification in these patients.
红细胞分布宽度（RDW）是炎症和氧化应激的标志物，其升高与危重症患者的不良预后相关。本荟萃分析旨在评估严重烧伤患者入院时RDW与短期死亡率之间的关联。
我们按照PRISMA 2020和Cochrane指南，系统检索了截至2024年8月的PubMed、Embase和Web of Science。纳入报告了入院时RDW和短期死亡率的成年严重烧伤患者的队列研究。使用随机效应模型进行荟萃分析，分别计算RDW和死亡率结局的平均差（MD）和相对风险（RR）。进行亚组分析和敏感性分析以评估异质性。
纳入了9项涉及5268例患者的队列研究。总体而言，非幸存者入院时的RDW高于幸存者[MD：0.95%，95%置信区间（CI）：0.52 - 1.38，p < 0.001，I² = 57%]。此外，高RDW与短期死亡风险增加相关（RR：1.76，95% CI：1.41 - 2.19，p < 0.001，I² = 77%）。每次排除一个数据集的敏感性分析证实了这些发现的稳健性。亚组分析显示，基于临床环境、患者年龄、性别、随访时间或研究质量，无显著差异。
入院时的RDW是严重烧伤患者短期死亡率的重要预测指标。这一发现凸显了RDW作为这些患者风险分层的简单有效标志物的潜在作用。
