The predictive performance of RDW for coronary artery lesions in children with Kawasaki disease: a systematic review and meta-analysis
- 1Department of emergency, West China Second University Hospital, Sichuan University, Chengdu, 610041 Sichuan China
- 2Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041 China
- 3Department of pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041 China
Abstract
Objective: Elevated red cell distribution width (RDW) may indicate an increased risk of coronary artery lesion (CAL) during the acute phase of Kawasaki disease (KD). This meta-analysis aimed to assess the predictive performance of RDW for CAL in children with KD.
Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies published until October 2025 that examined RDW’s role in predicting CAL in KD. Two researchers independently screened studies, extracted data, and evaluated study quality using the QUADAS-2 tool. Statistical analysis was conducted with STATA 15.1. Substantial heterogeneity was observed across studies, and meta-regression was performed to explore potential sources.
Results: Eight retrospective studies involving 3,058 KD patients were included; among them, 1,126 (36.82%) developed CAL. The meta-analysis showed that RDW-CV had a sensitivity of 0.64 (95% CI: 0.55–0.73) and specificity of 0.84 (95% CI: 0.73–0.92); the DOR was 9.67 (95% CI: 3.67–24.81). The PLR and NLR were found to be 4.10 (95% CI: 2.11–7.94) and 0.42 (95% CI: 0.31–0.58), respectively; SROC analysis indicated an area under the curve of 0.78 (95% CI: 0.74–0.81).
Conclusion: RDW-CV demonstrates moderate diagnostic performance for predicting CAL in children with KD. It may serve as a complementary and readily available biomarker, particularly when used in combination with other clinical and laboratory parameters, rather than as a standalone predictor. Given the substantial heterogeneity across studies, future prospective research with standardized protocols is warranted.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07510-1.
Related
- Risk Factors for Coronary Artery Aneurysms in Children With Kawasaki Disease
- Clinical outcomes of rivaroxaban and warfarin for anticoagulation in children with giant coronary artery aneurysms after Kawasaki disease
- Relationship between serum Interleukin-6 during the acute phase of children with Kawasaki disease and the coronary artery lesions
- Efficacy and Safety of Adjunctive Corticosteroids in Children With Kawasaki Disease: A Systematic Review and Meta-Analysis of Randomized Trials
- Anatomical distribution pattern of coronary artery lesions in Kawasaki disease and the prognostic value of dynamic Z-scores for recovery time: a retrospective cohort study
BibTeX
@article{tang2026predictive,
title = {{The predictive performance of RDW for coronary artery lesions in children with Kawasaki disease: a systematic review and meta-analysis}},
author = {Fajuan Tang and Shanshan Wu and Xiaoyan Zhang and Chengshuang Huang and Lina Qiao and Lingli Pan},
journal = {BMC Pediatrics},
year = {2026},
month = aug,
doi = {10.1186/s12887-026-07510-1},
url = {https://doi.org/10.1186/s12887-026-07510-1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The predictive performance of RDW for coronary artery lesions in children with Kawasaki disease: a systematic review and meta-analysis
AU - Fajuan Tang
AU - Shanshan Wu
AU - Xiaoyan Zhang
AU - Chengshuang Huang
AU - Lina Qiao
AU - Lingli Pan
PY - 2026
DA - 2026/08/12
JO - BMC Pediatrics
DO - 10.1186/s12887-026-07510-1
UR - https://doi.org/10.1186/s12887-026-07510-1
AB - Objective: Elevated red cell distribution width (RDW) may indicate an increased risk of coronary artery lesion (CAL) during the acute phase of Kawasaki disease (KD). This meta-analysis aimed to assess the predictive performance of RDW for CAL in children with KD. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies published until October 2025 that examined RDW’s role in predicting CAL in KD. Two researchers independently screened studies, extracted data, and evaluated study quality using the QUADAS-2 tool. Statistical analysis was conducted with STATA 15.1. Substantial heterogeneity was observed across studies, and meta-regression was performed to explore potential sources. Results: Eight retrospective studies involving 3,058 KD patients were included; among them, 1,126 (36.82%) developed CAL. The meta-analysis showed that RDW-CV had a sensitivity of 0.64 (95% CI: 0.55–0.73) and specificity of 0.84 (95% CI: 0.73–0.92); the DOR was 9.67 (95% CI: 3.67–24.81). The PLR and NLR were found to be 4.10 (95% CI: 2.11–7.94) and 0.42 (95% CI: 0.31–0.58), respectively; SROC analysis indicated an area under the curve of 0.78 (95% CI: 0.74–0.81). Conclusion: RDW-CV demonstrates moderate diagnostic performance for predicting CAL in children with KD. It may serve as a complementary and readily available biomarker, particularly when used in combination with other clinical and laboratory parameters, rather than as a standalone predictor. Given the substantial heterogeneity across studies, future prospective research with standardized protocols is warranted. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07510-1.
SN - 1471-2431
ER -