Assessment of Red Blood Cell Distribution Width as an Early Predictor of Persistent Organ Failure in Patients with Acute Pancreatitis

Aim Red cell distribution width is a parameter reflecting the size variability of peripheral erythrocytes. The elevation of red cell distribution width was correlated with adverse outcomes in several clinical conditions. Study has shown that red cell distribution width was predictive of mortality in acute pancreatitis. Acute pancreatitis patients with persistent organ failure show extremely high morbidity and mortality. The association underlying red cell distribution width and POF in acute pancreatitis has not been elucidated. Methods From March 2016 to January 2017, consecutive patients with confirmed acute pancreatitis were included in this retrospective study. Clinical parameters upon presentation, assessments concerning organ failure and disease outcomes were compared between patients with and without persistent organ failure. Logistic regression analyses were used to evaluate the relationship between red cell distribution width and persistent organ failure. Results A total of 158 patients, including 38 with persistent organ failure, were included. Compared to patients without persistent organ failure, persistent OF ones showed a significantly higher median value of red cell distribution width upon presentation (13.75 [13.30-14.38] % vs. 13.00 [12.60-13.60] %, P<0.001). After unit-and multi-variable analysis, red cell distribution width remained an independent risk factor for persistent organ failure (Hazard ratio 2.26, 95% confident interval: 1.46-3.51; P<0.001). Red cell distribution width predicted persistent organ failure with an area under the curve of 0.791, a sensitivity with 97.4% and specificity with 55.8%, respectively. The best cut-off value was 13.05 %. Conclusion Our results indicate that admission red cell distribution width is independently related with persistent organ failure in acute pancreatitis and may act as an early predictor.


Tao Peng, Xiaoyan Zuo, Yushun Zhang, Chunyou Wang, Heshui Wu

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