title: Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies.
abstract: OBJECTIVE
  Multiple studies have investigated the prognostic role of red blood cell distribution width (RDW) for patients with heart failure (HF), but the results have been inconsistent. The aim of the present study was to estimate the impact of RDW on the prognosis of HF by performing a systematic review and meta-analysis.
  
  
  RESULTS
  The Embase, PubMed, and Web of Science databases were searched up to November 16, 2013 to identify eligible cohort studies. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). The association between RDW, either on admission or at discharge, and HF outcomes (all-cause mortality [ACM], heart transplantation, cardiovascular mortality, and rehospitalization, etc.) were reviewed. The overall hazard ratio (HR) for the effect of RDW on ACM was pooled using a random-effects model, and the publication bias was evaluated using funnel plots and Eggers' tests. Seventeen studies, with a total of 18288 HF patients, were included for systematic review. All eligible studies indicated that RDW on admission and RDW at discharge, as well as its change during treatment, were of prognostic significance for HF patients. The HR for the effect of a 1% increase in baseline RDW on ACM was 1.10 (95% confidence interval: 1.07-1.13), based on pooling of nine studies that provided related data. However, publication bias was observed among these studies.
  
  
  CONCLUSIONS
  HF patients with higher RDW may have poorer prognosis than those with lower RDW. Further studies are needed to explore the potential mechanisms underlying this association.
authors.affiliation: Department of Laboratory Medicine, NO. 455 Hospital of People's Liberation Army, Shanghai, P. R. China; Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China; Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Yuan-Lan
authors.initials: YL
authors.lastname: Huang
authors.affiliation: Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China; Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of People's Liberation Army, Ji'nan, Shandong Province, P. R. China.
authors.forename: Zhi-De
authors.initials: ZD
authors.lastname: Hu
authors.affiliation: Department of Biobank and Biostatistics, Pediatric Translational Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Shi-Jian
authors.initials: SJ
authors.lastname: Liu
authors.affiliation: Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Qin
authors.affiliation: Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Bao-Dong
authors.initials: BD
authors.lastname: Qin
authors.affiliation: Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Ren-Qian
authors.initials: RQ
authors.lastname: Zhong
authors.affiliation: Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: An-Mei
authors.initials: AM
authors.lastname: Deng
mesh_terms: D015331:Cohort Studies; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology; D006333:Heart Failure / Q000401:mortality / Q000473:pathology*; D006801:Humans; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis