New predictor of acute necrotizing pancreatitis: Red cell distribution width

Yalçın, Mehmet Suat; Taş, Adnan; Kara, Banu; Ölmez, Şehmus; Sarıtaş, Bünyamin

doi:10.17219/acem/67590

Cited by 12 publications

(11 citation statements)

References 17 publications

(27 reference statements)

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“…Interestingly, in our study, mortality was only 8%, and multiorgan failure was the main cause of death . Moreover, mortality in our series was far lower than that of the general population . Perhaps the reduced inflammatory response due to the relative immunosuppression in the elderly may account for a less common development of severe disease.…”

Section: Discussioncontrasting

confidence: 57%

“…In the majority of patients, the disease presents as a mild, self‐limiting condition; in such a case, the overall mortality rate is 7% . AP develops into severe disease in 20% of cases, with mortality rates of up to 15–20% . Outcomes of AP in the elderly seem to be worse than in younger people as higher mortality rates and longer hospital stay had been reported .…”

Section: Introductionmentioning

confidence: 99%

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Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

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Background and Aim Acute pancreatitis (AP) is a common disease, but data on outcomes in octogenarians are scarce in the literature. The aim of this study is to analyze results from patients aged 80 years old and over who were treated for AP at a single center. Methods Patients aged 80 years and older diagnosed with AP from April 2010 to October 2015 were considered. Demographics, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), serum biochemistry at 24 and 48 h after admission, and revised Atlanta severity score were analyzed and correlated with hospital mortality rate and length of stay using the multiple regression and Kaplan–Meier tests. Results A total of 100 consecutive patients were included in the study. There were 52 women, and the mean age was 87.5 years (range 80–95). Gallstones were the most common cause of AP (69.7%). The ASA score was ≥III in 51 patients. Eight patients had severe, disease and all of them died in hospital. A CCI > 4 was associated with higher disease severity and mortality (P < 0.00001). The median hospital stay was 9 days (range 1–59). Longer hospital stay was associated with serum C‐reactive protein ≥242 mg/L (P = 0.01) and serum albumin ≤30 g/L (P = 0.01) at 48 h. Over a 5‐year period, 22% of patients were readmitted to hospital with recurrent AP. Gallstones were the main cause of disease (63.6%). Conclusions AP in octogenarians has low mortality. Higher death rate is associated with disease severity. In the presence of gallstone disease, cholecystectomy is recommended whenever possible as the risk of disease recurrence is significant.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

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“…[21–23] Preliminary studies revealed that RDW is positively associated with AP severity, and is likely a useful predictive parameter of AP severity. [11,24] Inflammatory status could change the RDW values. However, the mechanism between RDW and severity of AP are yet unknown, but previous researches indicated that it may be attributed to the following reasons.…”

Section: Discussionmentioning

confidence: 99%

“…[11] Inflammation promotes the death of red blood cells (RBC) or inhibits maturation of RBC, thus decreasing RBC lifespan. [24] Shortage of RBC synthetic materials (including iron, vitamin B 12 , and folic acid) promote the RBC cannot get enough iron. [25] Inflammatory cytokines can desensitize bone marrow erythroid progenitors to erythropoietic, blocking its antiapoptotic and promoting maturation effects.…”

Section: Discussionmentioning

confidence: 99%

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

Zhou

Xue

et al. 2019

Medicine

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Severity stratification and prognostic prediction at early stage is crucial for reducing the rates of mortality of patients with acute pancreatitis (AP). We aim to investigate the predicting performance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red-cell distribution width (RDW) combined with severity scores (sequential organ failure assessment [SOFA], bed-side index for severity of AP [BISAP], Ranson criteria, and acute physiology and chronic health evaluation II [APACHE II]) for severe AP (SAP) and mortality. A total of 406 patients diagnosed with AP admitted in a tertiary teaching hospital were enrolled. Demographic information and clinical parameters were retrospectively collected and analyzed. NLR, PLR, RDW, blood urea nitrogen (BUN), and AP severity scores (SOFA, BISAP, Ranson, and APACHE II) were compared between different severity groups and the survival and death group. Receiver-operating characteristic (ROC) curves for SAP and 28-day mortality were calculated for each predictor using cut-off values. Area under the curve (AUC) analysis and logistic regression models were performed to compare the performance of laboratory biomarkers and severity scores. Our results showed that NLR, PLR, RDW, glucose, and BUN level of the SAP group were significantly increased compared to the mild acute pancreatitis (MAP) group on admission ( P < .001). The severity of AP increased as the NLR, SOFA, BISAP, and Ranson increased ( P < .01). The AUC values of NLR, PLR, RDW, BUN, SOFA, BISAP, Ranson, and APACHE II to predict SAP were 0.722, 0.621, 0.787, 0.677, 0.806, 0.841, 0.806, and 0.752, respectively, while their AUC values to predict 28-day mortality were 0.851, 0.693, 0.885, 0.765, 0.968, 0.929, 0.812, and 0.867, respectively. BISAP achieved the highest AUC, sensitivity and NPV in predicting SAP, while SOFA is the most superior in predicting mortality. The combination of BISAP + RDW achieved the highest AUC (0.872) in predicting SAP and the combination of SOFA + RDW achieved the highest AUC (0.976) in predicting mortality. RDW (OR = 1.739), SOFA (OR = 1.554), BISAP (OR = 2.145), and Ranson (OR = 1.434) were all independent risk factors for predicting SAP, while RDW (OR = 7.361) and hematocrit (OR = 0.329) were independent risk factors for predicting mortality by logistic regression model. NLR, PLR, RDW, and BUN indicated good predictive value for SAP and mortality, while RDW had the highest discriminatory capacity. RDW is a convenient and reliable indicator for prediction not only SAP, but also mortality.

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“…Son zamanlarda, AP şiddeti gibi başka hastalıkları da öngörebilmek için tam kan sayımı parametreleri ile sıklığı gitgide artan çalışmalar yapılmaktadır (5)(6)(7). Bu parametrelere ek olarak, kırmızı hücre dağılım hacmi (RDW) ve ortalama trombosit hacmi (MPV) de inflamasyon ile seyreden hastalıklarda anlamlı olarak arttığı görülmüştür (8,9).…”

Section: Introductionunclassified

The Relationship Between Acute Pancreatitis Severity of Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, Erythrocyte Distribution Width and Mean Platelet Volume

Önmez

Bilir

Torun

2019

Konuralp Tıp Dergisi

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Bu çalışmada sistemik inflamasyon ile ilişkili bir marker olduğu gösterilen; Nötrofillenfosit oranı (NLR), platelet-lenfosit oranı (PLR), ortalama trombosit hacmi (MPV) ve Eritrosit dağılım hacmi (RDW) ile akut pankreatitin (AP) başvuru anındaki ciddiyetini gösteren Ranson kriteri ile aralarındaki ilişkinin gösterilmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2017 ile Kasım 2018 tarihleri arasında AP tanısı ile takip eden hastaların verilerine retrospektif olarak ulaşıldı. 82 biliyer ve 15 nonbiliyer olmak üzere toplam 139 hasta çalışmaya alındı. Hastaların ilk başvuru anında bakılan hemogram ve biyokimyasal parametreleri, yaşları, cinsiyetleri, ko-morbiditeleri ve yatış süreleri kaydedildi. İlk başvuru anında bakılan Ranson Kriterlerine göre skoru < 3 ve skoru ≥ 3 pozitif olanlar olmak üzere 2 gruba ayrıldı ve bu gruplar karşılaştırıldı. Bulgular: AP tanısı ile takip edilen 139 hastanın 75 (%54)'i erkek, 64 (%46)'ü kadındı. Hastaların 113'ü Ranson kriterlerine göre 3'ün altında 26'sı ise 3 ve üzerindeydi. Ortalama yaş hafif AP grubunda 61±20 yıl, şiddetli AP grubunda ise 70±13 yıldı. MPV (P< 0.001) ve NLR (P< 0.001) değerleri gruplar arasında anlamlı olarak farklı saptandı. Korelasyon analizinde; NLR ile ranson skoru arasında pozitif korelasyon saptandı (r= 0,253 p<0,01). Yapılan Lineer Regresyon analizi sonucunda, NLR ve PLR'nin AP şiddetini göstermede bağımsız prediktör oldukları bulundu. Sonuç: Sistemik inflamasyonu gösteren çalıştığımız parametrelerden NLR, AP'nin şiddetini belirlemede basit ve güvenilir bir gösterge olarak kullanılabilir.

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New predictor of acute necrotizing pancreatitis: Red cell distribution width

Cited by 12 publications

References 17 publications

Outcome of acute pancreatitis in octogenarians: A retrospective study

Outcome of acute pancreatitis in octogenarians: A retrospective study

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

The Relationship Between Acute Pancreatitis Severity of Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, Erythrocyte Distribution Width and Mean Platelet Volume

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