Red Cell Distribution Width as a Diagnostic and Prognostic Marker in Hospitalized Pediatric Patients: A Pilot Study from Yemen

Background and Objective: Red cell distribution width (RDW) is a routinely reported parameter in the Complete Blood Count (CBC), traditionally used in the diagnosis of anemia. Recent studies indicate that RDW may also serve as a valuable diagnostic and prognostic marker in a range of diseases. Despite this growing evidence, the significance of RDW in pediatric populations, especially within resource-limited settings, remains insufficiently investigated. This study was aimed to assess the distribution of RDW among hospitalized pediatric patients and explore its association with different disease categories. Materials and Methods: This retrospective study included 143 pediatric admissions aged 1 month to 14 years at a tertiary care hospital in Yemen. The RDW values were categorized as normal (≤14.5%) or high (>14.5%). Cases were grouped by major disease systems (e.g., gastrointestinal, respiratory, hematological). Descriptive statistics and chi-square tests were used for analysis. The p-value <0.05 was considered statistically significant. Results: Elevated RDW was observed in 91 (63.6%) cases. The highest proportions were found in inflammatory (100.0%) and hematological (96.0%) diseases. High RDW was also common in endocrine (75.0%) and nervous system (68.4%) conditions. Gastrointestinal, respiratory, and infectious diseases showed nearly equal distribution of normal and high RDW. A significant association was found between RDW status and disease system (χ² = 23.05, p = 0.006), while subcategory-level comparisons were not statistically significant. Conclusion: The RDW was frequently elevated in pediatric admissions, particularly in hematological and inflammatory diseases. Its association with specific disease systems suggests potential as a supportive diagnostic marker in pediatrics. Further prospective studies are needed to clarify the role of RDW, especially in settings where anemia and inflammation are common.