Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
IF – 2.1 (5-Year IF – 2.0), JCI (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker – 4.3)
Q1 in SJR 2024, SJR score – 0.598
IC – 171.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 2, February, p. 225–228

doi: 10.17219/acem/67590

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

New predictor of acute necrotizing pancreatitis: Red cell distribution width

Mehmet Suat Yalçın1,A, Adnan Tas1,F, Banu Kara1,B, Sehmus Olmez1,C, Bunyamin Saritas2,D

1 Department of Gastroenterology, Adana Numune Research and Educational Hospital, Turkey

2 Department of Gastroenterology, Mersin University Medical Faculty, Adana, Turkey

Abstract

Background. Acute pancreatitis (AP) is inflammation of the pancreas of various severity ranging from mild abdominal pain to mortality. AP may be classified as acute interstitial edematous pancreatitis (AEP) or acute necrotizing pancreatitis (ANP), according to the revised Atlanta criteria. Most of the patients with AP are AEP (75–85% of patients), while 15–25% of patients have ANP. The mortality rate is 3% in AEP and 15% in ANP. Thus, it is important to predict the severity of AP to decrease the morbidity and mortality.
Objectives. The aim of the study was to evaluate the relationship between red cell distribution width (RDW) and the severity of AP on admission to hospital.
Material and Methods. Patients admitted to Adana Numune Research and Educational Hospital with a diagnosis of AP through the time frame of January 2014–May 2016 were included in our study. Diagnosis of AP was made according to the revised Atlanta classification. Patients’ age, sex, etiology of AP, and RDW values were recorded on admission to the hospital.
Results. A total of 180 patients were included in the study. Eighty patients (44%) were male and 100 patients were female. Mean age was 56.25 ±18.3 years (52.66 ±14.4 in males; 59.84 ±20.2 in females). There was no statistically significant difference between patients’ age. The most frequently observed etiologic factor was gallstone disease followed by alcohol intake and the use of pharmaceuticals. Drug-related AP was associated with azathioprine, furosemide, and thiazide diuretics. One hundred forty-four (80%) patients had AEP and 36 (20%) patients had ANP. RDW values showed a statistically significant difference between patients with AEP and ANP (p = 0.011). The cut-off value of RDW was 16.4 and the area under curve (AUC) value was 0.591 (p = 0.0227) with a sensitivity of 29.2% and specificity of 89.83%.
Conclusion. Red cell distribution width could be used to evaluate the prognosis of acute pancreatitis.

Key words

acute pancreatitis, acute necrotizing pancreatitis, red cell distribution width

References (20)

  1. Otsuki M, Takeda K, Matsuno S, et al. Criteria for the diagnosis and severity stratification of acute pancreatitis. World J Gastroenterol. 2013;19(35):5798–5805.
  2. Stevenson K, Carter CR. Acute pancreatitis. Surgery (Oxford). 2013; 31(6):295–303.
  3. Banks PA, Gerzof SG, Langevin RE, et al. Classification of acute pancreatitis – 2012: Revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111.
  4. van Santvoort HC, Bakker OJ, Bollen TL, et al. A Conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141(4):1254–1263.
  5. Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepatol.2011;9(12):1098–1103.
  6. Rau BM. Predicting severity of acute pancreatitis. Curr Gastroenterol Rep. 2007;9(2):107–115.
  7. Zuidema MJ, van Santvoort HC, Besselink MG, et al. The predictive value of proteinuria in acute pancreatitis. Pancreatology. 2014;14(6): 484–489.
  8. England JM, Down MC. Red-cell-volume distribution curves and the measurement of anisocytosis. Lancet. 1974;1(7860):701–703.
  9. Fornal M, Wizner B, Cwynar M, et al. Association of red blood cell distribution width, inflammation markers and morphological as well as rheological erythrocyte parameters with target organ damage in hypertension. Clin Hemorheol Microcirc. 2014;56(4):325–335.
  10. Hu ZD, Sun Y, Guo J, et al. Red blood cell distribution width is a potential index to assess the disease activity of systemic lupus erythematosus. Clin Chim Acta. 2013;425:202–205.
  11. Aslan D, Gumruk F, Gurgey A, et al. Importance of RDW value in differential diagnosis of hypochrome anemias. Am J Hematol. 2002;69(1): 31–33.
  12. AlFadhli SM, Al-Awadhi AM, AlKhaldi D. Validity assessment of nine discriminant functions used for the differentiation between iron deficiency anemia and thalassemia minor. J Trop Pediatr. 2007;53(2):93–97.
  13. Kurt M, Tanboga IH, Buyukkaya E, et al. Relation of red cell distribution width with CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation. Clin Appl Thromb Hemost. 2014;20(7):687–692.
  14. Demir R, Saritemur M, Ozel L, Ozdemir G, Emet M, Ulvi H. Red cell distribution width identifies cerebral venous sinus thrombosis in patients with headache. Clin Appl Thromb Hemost. 2015;21(4):354–358.
  15. Solak Y, Yilmaz MI, Saglam M, et al. Red cell distribution width is independently related to endothelial dysfunction in patients with chronic kidney disease. Am J Med Sci. 2014;347(2):118–124.
  16. Kim HM, Kim BS, Cho YK, et al. Elevated red cell distribution width is associated with advanced fibrosis in NAFLD. Clin Mol Hepatol. 2013; 19(3):258–265.
  17. Wang D, Wang R, Liu M, et al. Red cell distribution width predicts deaths in patients with acute pancreatitis. J Res Med Sci. 2015;20(5): 424–428.
  18. Guo ZH, Hao JY. The review of acute pancreatitis scoring system. Chin J Clin Hepatol. 2011;27:1170–1173 [in Chinese].
  19. Şenol K, Saylam B, Kocaay F, et al. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med. 2013;31(4): 687–689.
  20. Yao J, Lv G. Association between red cell distribution width and acute pancreatitis: A cross-sectional study. BMJ Open. 2014;4:e004721.
© Wroclaw Medical University