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Minerva Pediatrics 2022 April;74(2):202-12

DOI: 10.23736/S2724-5276.21.06149-1


lingua: Inglese

Diagnostic accuracy of red blood cell distribution width for neonatal sepsis

Zhi-Yuan LIU 1, 2, Hui-Zhen JIANG 3, Li WANG 4, Ming-Xiao CHEN 1, 2, Hong-Tao WANG 1, 2, Jia-Xiang ZHANG 1, 2

1 School of Public Health, Department of Occupational Health and Environmental Health, Anhui Medical University, Hefei, Anhui, China; 2 The Second School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China; 3 Department of Pediatrics, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; 4 Department of Neonatology, Qingdao Women and Children’s Hospital, Qingdao, China

INTRODUCTION: Red blood cell distribution width (RDW) is a biomarker for the diagnosis and prognosis of many diseases. However, the relevance between RDW and neonatal sepsis (NS) have not reached a consensus yet; the perform of RDW in the diagnosis of neonatal sepsis is still not clear. The aim of this meta-analysis was to estimate the significance of RDW in neonatal sepsis and the perform of RDW in diagnosis of neonatal sepsis.
EVIDENCE ACQUISITION: We used Pubmed, Embase, Web of science, CNKI and Google academic database to find all articles that met the inclusion criteria until July 1, 2020.
EVIDENCE SYNTHESIS: Fifteen eligible studies involving 1362 newborns were included in the meta-analysis after two independent investigators read the title, abstract and full text in detail. The pooled result of this meta-analysis showed that RDW was significantly higher in the NS group than in the control group (WMD=3.224; 95%CI: 2.359-4.090, P<0.001). In addition, the overall pooled sensitivity, specificity, PLR, NLR and DOR were 0.88 (95%CI:0.66-0.96), 0.90 (95%CI:0.65-0.98), 9.2 (95%CI:2.1-40.3), 0.14(95%CI:0.04-0.43) and 66.9 (95%CI:8.73-513.26), respectively. The area under the SROC curve (AUC) was 0.95 (95%CI:0.93-0.96).
CONCLUSIONS: The meta-analysis demonstrated that newborns with sepsis had an elevated RDW level than healthy controls. RDW levels have significant correlated with neonatal sepsis; and RDW can be used as a cheap and satisfactory diagnostic biomarker for neonatal sepsis with a relatively high performance.

KEY WORDS: Erythrocyte indices; Neonatal sepsis; Meta-analysis; Biomarkers

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