Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases
<i>Background</i>: Despite great advances in medicine, numerous available laboratory markers, and radiological imaging, the diagnosis of acute appendicitis (AA) in some cases still remains controversial and challenging for clinicians. Because of that, clinicians are still looking for an...
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MDPI AG
2022-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/4/1011 |
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| author | Sachit Anand Nellai Krishnan Miro Jukić Zvonimir Križanac Carlos Martin Llorente Muñoz Zenon Pogorelić |
| author_facet | Sachit Anand Nellai Krishnan Miro Jukić Zvonimir Križanac Carlos Martin Llorente Muñoz Zenon Pogorelić |
| author_sort | Sachit Anand |
| collection | DOAJ |
| description | <i>Background</i>: Despite great advances in medicine, numerous available laboratory markers, and radiological imaging, the diagnosis of acute appendicitis (AA) in some cases still remains controversial and challenging for clinicians. Because of that, clinicians are still looking for an ideal marker that would be specific to AA. The red blood cell distribution width (RDW) has been recently investigated in several studies as a potential biomarker for AA. The aim of this systematic review and meta-analysis was to systematically summarize and compare all relevant data on RDW as a diagnostic biomarker for AA. <i>Methods</i>: This systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Scopus, Web of Science, and Excerpta Medica database—EMBASE) were systematically searched for relevant comparative studies by two independent researches using keywords ((red cell distribution width) OR rdw) AND (appendicitis). An independent assessment of the methodological quality was performed by two authors using the Downs and Black scale. RevMan 5.4 software was used to perform the meta-analysis. <i>Results</i>: Fifteen studies were included in the final meta-analysis; the majority of the studies was retrospective. Nine studies compared the RDW values between AA and non-AA; four studies compared the same between AA and healthy controls, while two studies compared the RDW values among all three groups. The estimated heterogeneity among the studies for all outcome was statistically significant (I<sup>2</sup> = 92–99%, <i>p</i> < 0.00001). The pooling the data demonstrated no statistically significant difference in the RDW values (weighted mean difference (WMD) = 0.03, 95% CI = (−0.46, 0.52), <i>p</i> = 0.91) between AA and healthy controls as well as between AA and non-AA cases (WMD = 0.23, 95%CI = (–0.19, 0.65), <i>p</i> = 0.28). A separate subanalysis was performed to evaluate the utility of this biomarker for the pediatric age group. Pooling the data demonstrated no significant difference among the AA and non-AA groups in terms of the RDW values (WMD = 0.99, 95% CI = (–0.35, 2.33), <i>p</i> = 0.15). <i>Conclusion</i>: The RDW value difference demonstrated no statistically significant difference in AA versus healthy individuals and AA versus non-AA individuals. At the moment, there is no evidence of RDW utility in diagnostic testing of AA. Further research with prospective, multicenter studies and studies targeting special patient groups with a large sample size are needed in this field. |
| first_indexed | 2024-03-09T10:56:49Z |
| format | Article |
| id | doaj.art-f59b59c953a44bdeb6576b9581bf7ce8 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T10:56:49Z |
| publishDate | 2022-04-01 |
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| series | Diagnostics |
| spelling | doaj.art-f59b59c953a44bdeb6576b9581bf7ce82023-12-01T01:38:07ZengMDPI AGDiagnostics2075-44182022-04-01124101110.3390/diagnostics12041011Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 CasesSachit Anand0Nellai Krishnan1Miro Jukić2Zvonimir Križanac3Carlos Martin Llorente Muñoz4Zenon Pogorelić5Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Pediatric Surgery, University Hospital of Split, 21000 Split, CroatiaDepartment of Surgery, University Hospital of Split, 21000 Split, CroatiaSurgical Clinic Medix-Muñoz, 28000 Madrid, SpainDepartment of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia<i>Background</i>: Despite great advances in medicine, numerous available laboratory markers, and radiological imaging, the diagnosis of acute appendicitis (AA) in some cases still remains controversial and challenging for clinicians. Because of that, clinicians are still looking for an ideal marker that would be specific to AA. The red blood cell distribution width (RDW) has been recently investigated in several studies as a potential biomarker for AA. The aim of this systematic review and meta-analysis was to systematically summarize and compare all relevant data on RDW as a diagnostic biomarker for AA. <i>Methods</i>: This systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Scopus, Web of Science, and Excerpta Medica database—EMBASE) were systematically searched for relevant comparative studies by two independent researches using keywords ((red cell distribution width) OR rdw) AND (appendicitis). An independent assessment of the methodological quality was performed by two authors using the Downs and Black scale. RevMan 5.4 software was used to perform the meta-analysis. <i>Results</i>: Fifteen studies were included in the final meta-analysis; the majority of the studies was retrospective. Nine studies compared the RDW values between AA and non-AA; four studies compared the same between AA and healthy controls, while two studies compared the RDW values among all three groups. The estimated heterogeneity among the studies for all outcome was statistically significant (I<sup>2</sup> = 92–99%, <i>p</i> < 0.00001). The pooling the data demonstrated no statistically significant difference in the RDW values (weighted mean difference (WMD) = 0.03, 95% CI = (−0.46, 0.52), <i>p</i> = 0.91) between AA and healthy controls as well as between AA and non-AA cases (WMD = 0.23, 95%CI = (–0.19, 0.65), <i>p</i> = 0.28). A separate subanalysis was performed to evaluate the utility of this biomarker for the pediatric age group. Pooling the data demonstrated no significant difference among the AA and non-AA groups in terms of the RDW values (WMD = 0.99, 95% CI = (–0.35, 2.33), <i>p</i> = 0.15). <i>Conclusion</i>: The RDW value difference demonstrated no statistically significant difference in AA versus healthy individuals and AA versus non-AA individuals. At the moment, there is no evidence of RDW utility in diagnostic testing of AA. Further research with prospective, multicenter studies and studies targeting special patient groups with a large sample size are needed in this field.https://www.mdpi.com/2075-4418/12/4/1011acute appendicitisappendicitisred cell distribution widthRDW |
| spellingShingle | Sachit Anand Nellai Krishnan Miro Jukić Zvonimir Križanac Carlos Martin Llorente Muñoz Zenon Pogorelić Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases Diagnostics acute appendicitis appendicitis red cell distribution width RDW |
| title | Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases |
| title_full | Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases |
| title_fullStr | Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases |
| title_full_unstemmed | Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases |
| title_short | Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases |
| title_sort | utility of red cell distribution width rdw as a noninvasive biomarker for the diagnosis of acute appendicitis a systematic review and meta analysis of 5222 cases |
| topic | acute appendicitis appendicitis red cell distribution width RDW |
| url | https://www.mdpi.com/2075-4418/12/4/1011 |
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