Value Of Red Blood Cell Distribution Width In Assessing The Severity And Prognostic Evaluation Of Pancreatitis

Objective: To explore the value of red blood cell distribution width(RDW)and its dynamic changes after admission in assessing the severity and prognostic evaluation of acute pancreatitis(AP).Methods: One hundred and twenty cases of AP patients including 43 cases of mild acute pancreatitis(MAP),32 cases of moderate severe acute pancreatitis(MSAP)and 45 cases of severe acute pancreatitis(SAP)from Jan.2010 to Jun.2017 in the in the Affiliated Hospital of Guilin Medical University were selected.According to the diagnostic is SAP or not,patients were divided into non-SAP group(75 cases)and SAP group(45 cases).Patients in SAP group were divided into survival group(25 cases)and death group(20 cases),30 healthy volunteers were selected as the control group.RDW of patients was collected at the time of admission and 48 hours after admission to hospital,as well as the RDW of the control group and other relevant clinical data were collected.The difference value of RDW in each group,the dynamic changes of the RDW and the correlation of RDW with Ranson score,APACHE II score were compared.The value of RDW to the severity and prognosis of AP were analyzed by the ROC curve and area under curve(AUC).Results: The RDW of SAP group at the time of admission and 48 hours after admission to hospital were significantly higher than those in the other three groups(P < 0.001).In the SAP group and MSAP group,the RDW at the time of admission was not significantly changed after 48 hours in hospital(P>0.05).RDW has good correlation with Ranson score and APACHE II score respectively.In a multiariable Logistic regression analysis,RDW,Ranson score and APACHE II score indexes at the time of admission were all independent risk factors for SAP diagnosis and hospital death(P < 0.05).The ROC curve analysis of the prediction value of SAP in admission showed that the RDW curve was 0.953(95% CI: 0.899~0.983,P<0.001).According to the Youden index,the optimal critical value of RDW when admission was 13.9 % and the sensitivity was 95.56 % and the specificity was 81.33 %.RDW on admission to hospital to prognosis of death in the hospital in SAP group of ROC curve analysis showed that RDW AUC was 0.849(95% CI: 0.711~0.938,P<0.001).According to the Youden index,the optimal critical value of RDW when admission was 16.2 % and the sensitivity was 70.00 % and the specificity was 92.00 %.Conclusion: RDW can predict the severity and prognosis of AP,and the dynamic change of RDW may have important value to predict the condition of it.