Background In the USA, acute pancreatitis (AP) was the third most prevalent gastrointestinal disease and it is the commonest pancreatic disease worldwide. It is critical to identify individuals at a higher risk of developing severe AP early to improve their prognosis. Several scoring systems to assess the severity of AP (e.g. Ranson’s criteria and acute physiologic assessment and chronic health-evaluation II) were developed. Aim The goal of this study was to see whether red-cell distribution width (RDW) could be used to predict the severity and mortality of AP. Patients and methods This prospective observational study included 50 patients admitted at Tanta University Emergency Hospital with AP. During the study, 46 patients survived, while four patients died, 31 patients discharged without complications, and 15 patients had complications. Results RDW had a significant relationship with complications of AP (P=0.005), also, RDW had a strong relationship to mortality (P=0.049). RDW had a sensitivity of 61.11% and a specificity of 84.37% in predicting complications. While RDW had a sensitivity and specificity of 75.0 and 95.65%, respectively, in predicting mortality. We also found that Ranson’s criteria had a significant relationship with complications and mortality of AP (P=0.024). The sensitivity and specificity of Ranson’s criteria to predict complications was 72.22 and 62.50%, respectively. While the sensitivity and specificity of Ranson’s criteria to predict mortality was 75.0 and 71.74%, respectively. Conclusion RDW seems to be a good test used to determine the severity of AP.
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