Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14450
Revised: April 5, 2014
Accepted: July 15, 2014
Published online: October 21, 2014
Processing time: 321 Days and 22.8 Hours
AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).
METHODS: Between January 2010 and June 2012, 102 patients with AP were recruited to the study. In this retrospective cohort study, for all subjects, demographic data on hospital admission, AP etiology, co-morbid diseases, organ failure assessment, laboratory parameters and length of hospital stay were examined. Additionally, we used a non-invasive prediction method in addition to the RPR to evaluate the disease severity. Multivariate logistic regression analyses were used to evaluate the impact of RPR on hospital admission to predict mortality.
RESULTS: The male-female ratio (59/43) was 1.37 with a median age of 56.5 years (17-89 years). In both univariate and multivariate analyses, RDW and RPR were presented as independent and significant variables on admission to predict mortality. The RPR obtained on hospital admission was persistently higher among non-survivors than among survivors (P < 0.0001). The median RPR was 0.000087 in the non-survivor group and 0.000058 in the survivor group. RPR with a cutoff value of 0.000067 presented an area under the curve of 0.783 (95%CI: 0.688-0.878) in receiver operating characteristic curves and could predict the mortality of approximately 80% of the patients.
CONCLUSION: We identified RPR as a valuable, novel laboratory test to predict mortality in AP.
Core tip: Although the majority of patients with acute pancreatitis have a mild course of the disease, severe forms require more attention because of their high morbidity and mortality. Several single- and multi-parameter scoring systems, including laboratory parameters, physiological and radiological assessments, have been described to evaluate disease severity. Sometimes, it is not clinically practicable to use these scoring systems for evaluation; therefore, an easy to use and accurate method is needed to predict mortality.