Hou Fei-Fei, Song Yong, Du Wei-Na, Wang Bei-Bei, Wang Qiong, Wu Qiong, Yan Li-Na, Chen Xin
Department of Intensive Care Unit, Inner Mongolia Medical University Affiliated Hospital, Hohhot, Inner Mongolia, P.R. China.
Department of Intensive Care Unit, Zibo Traditional Chinese Medicine Hospital, Zibo, Shandong, P.R. China.
Medicine (Baltimore). 2025 Jun 6;104(23):e42701. doi: 10.1097/MD.0000000000042701.
Critically ill patients with acute respiratory distress syndrome (ARDS) are one of the leading causes of death worldwide. Although a number of relevant predictors of ARDS have been identified, the current predictors are not satisfactory. Recent studies have revealed the predictive value of red blood cell distribution width (RDW) for ARDS. Therefore, we conducted the first meta-analysis to explore the predictive value of RDW in critically ill patients with ARDS.
A literature search was conducted to identify relevant observational studies from January 1, 2000, to August 1, 2024. Eligible studies were screened and data were extracted. The standardized mean difference (SMD) with 95% confidence interval (CI) of the RDW levels for each study were combined under the random-effect model.
Ten articles with a total of 2252 participants were included in the study. Elevated RDW levels on admission was significantly associated with significantly associated with an increased risk of ARDS morbidity (SMD = 1.09; 95% CI = 0.35-1.82; P = .004), and also significantly associated with an increased risk of ARDS mortality (SMD = 0.73; 95% CI = 0.53-0.93; P < .00001). Subgroup analysis further showed RDW ≥ 14.0 on admission could be regarded as a predictive morbidity factor for ARDS (SMD = 1.36; 95% CI = 0.66-2.07; P = .0002), and RDW ≥ 15.5 on admission could be also regarded as a predictive mortality factor for ARDS (SMD = 0.73; 95% CI = 0.49-0.97; P < .00001).
RDW levels seems to be a useful tool for predicting the morbidity and mortality of critically ill patients with ARDS.
急性呼吸窘迫综合征（ARDS）的重症患者是全球主要死亡原因之一。尽管已确定了一些ARDS的相关预测指标，但目前的预测指标并不令人满意。最近的研究揭示了红细胞分布宽度（RDW）对ARDS的预测价值。因此，我们进行了首次荟萃分析，以探讨RDW在ARDS重症患者中的预测价值。
进行文献检索，以确定2000年1月1日至2024年8月1日期间的相关观察性研究。筛选符合条件的研究并提取数据。在随机效应模型下合并每项研究的RDW水平的标准化平均差（SMD）及其95%置信区间（CI）。
该研究纳入了10篇文章，共2252名参与者。入院时RDW水平升高与ARDS发病风险增加显著相关（SMD = 1.09；95% CI = 0.35 - 1.82；P = 0.004），也与ARDS死亡风险增加显著相关（SMD = 0.73；95% CI = 0.53 - 0.93；P < 0.00001）。亚组分析进一步表明，入院时RDW≥14.0可被视为ARDS的发病预测因素（SMD = 1.36；95% CI = 0.66 - 2.07；P = 0.0002），入院时RDW≥15.5也可被视为ARDS的死亡预测因素（SMD = 0.73；95% CI = 0.49 - 0.97；P < 0.00001）。
RDW水平似乎是预测ARDS重症患者发病和死亡的有用工具。
