ORIGINALS
IMAJ | volume 27
Journal 2, February 2025
pages: 87-91
The Association Between Red Blood Cell Distribution Width at Admission and Early Mortality in Acute Pancreatitis
1 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
2 Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
3 Heart Institute, Rambam Health Care Campus, Haifa, Israel
4 Department of Medicine, Rambam Health Care Campus, Haifa, Israel
5Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
6 Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
7 Department of Surgery, Nazareth Hospital EMMS, Nazareth, Israel
Summary
Background:
Several studies have shown an association between increased red blood cell distribution width (RDW) and adverse outcomes in various acute diseases. Small studies have suggested that RDW is a useful predictor of acute pancreatitis severity.
Objectives:
To determine the association between RDW at admission and early mortality in acute pancreatitis. To assess whether RDW adds to the predictive ability of the Glasgow Imrie Score.
Methods
:
In this observational study, we included all adult patients admitted with a primary diagnosis of acute pancreatitis between January 2008 and June 2021. Patients were divided into two groups according to RDW: normal RDW (RDW ≤ 14.5%) and elevated RDW (RDW > 14.5%).
Results:
Within 30 days of admission, 29/438 patients (6.6%) with increased RDW and 20/1250 patients (1.6%) with normal RDW had died: univariate analysis (odds ratio 4.6, 95% confidence interval 2.45–7.9,
P < 0.001), fully adjusted model (odds ratio 3.29, 95% confidence interval 1.75–6.26,
P < 0.001). We calculated receiver operating characteristic curve (ROC) for RDW alone, Glasgow Imrie Score alone, and a combination of Glasgow Imrie Score with RDW. We assessed their ability to predict 30-day mortality. Area under the ROC curve (AUC) of RDW alone was 0.671 and Glasgow Imrie Score AUC was 0.682; Glasgow Imrie Score plus RDW had an AUC of 0.769.
Conclusions:
In patients with acute pancreatitis, elevated RDW at admission was independently associated with increased 30-day mortality. The addition of RDW to a pancreatitis prognostic tool such as the Glasgow Imrie Score improves its predictive ability.