Outcome prediction for patients with sepsis may be conductive to early aggressive interventions. Numerous biomarkers and multiple scoring systems have been utilized in predicting outcomes, however, these tools were either expensive or inconvenient. We performed a meta-analysis to evaluate the prognostic role of red blood cell distribution width (RDW) in patients with sepsis. The online databases of Embase, Web of science, Pubmed, Corchrane library, Chinese Wanfang database, CNKI database were systematically searched from the inception dates to June, 24th, 2020, using the keywords red cell distribution width and sepsis. The odds ratio (OR) or Hazards ratio (HR) with corresponding 95% confidence intervals (95%CI) were pooled to evaluate the association between baseline RDW and sepsis. A random-effects model was used to pool the data, and statistical heterogeneity between studies was evaluated using the I2 statistic. Sensitivity and subgroup analyses were performed to detect the publication bias and origin of heterogeneity. Eleven studies with 17,961 patients with sepsis were included in the meta-analysis. The pooled analyses indicated that increased baseline RDW was associated with mortality (HR = 1.14, 95%CI 1.09–1.20, Z = 5.78, P < 0.001) with significant heterogeneity (I2 = 80%, Pheterogeneity < 0.001). Similar results were found in the subgroup analysis stratified by site of infection, comorbidity, Newcastle-Ottawa Scale (NOS) score, study design, patients’ country. The predefined subgroup analysis showed that NOS score may be the origin of heterogeneity. For patients with sepsis, baseline RDW may be a useful predictor of mortality, patients with increased RDW are more likely to have higher mortality.

中文翻译：

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红细胞分布宽度在脓毒症患者中的预后作用：系统评价和荟萃分析。

脓毒症患者的预后预测可能有助于早期积极干预。许多生物标志物和多个评分系统已被用于预测结果，但是，这些工具要么昂贵，要么不方便。我们进行了一项荟萃分析来评估红细胞分布宽度 (RDW) 在脓毒症患者中的预后作用。以红细胞分布宽度和脓毒症为关键词，系统检索Embase、Web of science、Pubmed、Corchrane library、中文万方数据库、CNKI数据库等在线数据库，从创建日期至2020年6月24日。将优势比 (OR) 或危险比 (HR) 与相应的 95% 置信区间 (95%CI) 合并以评估基线 RDW 与败血症之间的关联。使用随机效应模型来合并数据，使用 I2 统计量评估研究之间的统计异质性。进行敏感性和亚组分析以检测发表偏倚和异质性来源。荟萃分析纳入了 11 项研究，涉及 17,961 名败血症患者。汇总分析表明，基线 RDW 增加与死亡率相关（HR = 1.14，95%CI 1.09–1.20，Z = 5.78，P < 0.001）且具有显着的异质性（I2 = 80%，Pheterogenity < 0.001）。在按感染部位、合并症、纽卡斯尔-渥太华量表 (NOS) 评分、研究设计、患者所在国家/地区分层的亚组分析中也发现了类似的结果。预定义的亚组分析显示NOS评分可能是异质性的起源。对于脓毒症患者，基线 RDW 可能是死亡率的有用预测指标，