Abstract：
BACKGROUND: Acute pancreatitis (AP) is a potentially fatal condition that varies in its severity at presentation. It\'s crucial to recognize patients with a higher likelihood of severe outcomes to enhance their prognosis by promptly providing medical or endoscopic treatment and admitting them to a specialized intensive care unit (ICU). Despite the various scoring systems and methods, there is no reliable instrument to assess the severity of AP at its presentation. Red cell distribution width (RDW) and serum calcium levels are inexpensive markers readily available upon admission that can be used to anticipate the severity of AP.
METHODS: An observational cross-sectional study was carried out on 85 patients admitted to a referral hospital. The AP patients were categorized into two groups: those with mild AP (MAP) and those with moderately severe/severe AP (MSAP/SAP). RDW was assessed in all patients upon admission and at the 24-hour mark.
RESULTS: Among the 85 AP patients, 55 were diagnosed with MAP, while 17 had MSAP and 13 had SAP. The mean serum calcium levels were notably lower in patients with MSAP/SAP compared to MAP. Additionally, the modified Marshall (MM) score, bedside index for severity in acute pancreatitis (BISAP) index, RDW at 0 hours and 24 hours, and RDW/total serum calcium (RDW/TSC) ratio were significantly higher in patients with MSAP/SAP than in MAP. The BISAP index, followed by MM, emerged as the most reliable predictors of severity, with RDW/TSC also showing strong predictive value. RDW/TSC demonstrated superior predictive ability for AP severity when compared to RDW measured at admission and at 24 hours. However, no individual parameter was identified as an independent significant predictor of AP.
CONCLUSIONS: Red cell distribution width and RDW/TSC ratio are comparable to BISAP index as predictors of severity in AP. They offer a cost-effective and readily accessible means to forecast AP severity upon admission, facilitating prompt intervention at the outset.
METHODS: An observational cross-sectional study was carried out on 85 patients admitted to a referral hospital. The AP patients were categorized into two groups: those with mild AP (MAP) and those with moderately severe/severe AP (MSAP/SAP). RDW was assessed in all patients upon admission and at the 24-hour mark.
RESULTS: Among the 85 AP patients, 55 were diagnosed with MAP, while 17 had MSAP and 13 had SAP. The mean serum calcium levels were notably lower in patients with MSAP/SAP compared to MAP. Additionally, the modified Marshall (MM) score, bedside index for severity in acute pancreatitis (BISAP) index, RDW at 0 hours and 24 hours, and RDW/total serum calcium (RDW/TSC) ratio were significantly higher in patients with MSAP/SAP than in MAP. The BISAP index, followed by MM, emerged as the most reliable predictors of severity, with RDW/TSC also showing strong predictive value. RDW/TSC demonstrated superior predictive ability for AP severity when compared to RDW measured at admission and at 24 hours. However, no individual parameter was identified as an independent significant predictor of AP.
CONCLUSIONS: Red cell distribution width and RDW/TSC ratio are comparable to BISAP index as predictors of severity in AP. They offer a cost-effective and readily accessible means to forecast AP severity upon admission, facilitating prompt intervention at the outset.
摘要：
背景：急性胰腺炎（AP）是一种潜在的致命性疾病，其严重程度各不相同。通过及时提供医学或内窥镜治疗并将其送入专门的重症监护病房（ICU），识别出严重预后可能性较高的患者以改善其预后至关重要。尽管有各种评分系统和方法，没有可靠的工具来评估AP出现时的严重程度.红细胞分布宽度（RDW）和血清钙水平是廉价的标记，可用于预测AP的严重程度。
方法：对转诊医院收治的85名患者进行了一项观察性横断面研究。AP患者分为两组：轻度AP（MAP）和中度/重度AP（MSAP/SAP）。在所有患者入院时和24小时时评估RDW。
结果：在85例AP患者中，55人被诊断为MAP，17人患有MSAP，13人患有SAP。与MAP相比，MSAP/SAP患者的平均血清钙水平明显较低。此外,修改后的马歇尔（MM）得分，急性胰腺炎严重程度的床旁指数（BISAP）指数，RDW在0小时和24小时，MSAP/SAP患者的RDW/血清总钙（RDW/TSC）比值明显高于MAP。BISAP指数，其次是MM,成为最可靠的严重程度预测因子，RDW/TSC也显示出较强的预测价值。与入院时和24小时测量的RDW相比，RDW/TSC对AP严重程度的预测能力更高。然而,没有个体参数被确定为AP的独立显著预测因子.
结论：红细胞分布宽度和RDW/TSC比率与BISAP指数相当，可以预测AP的严重程度。他们提供了一种具有成本效益且易于获得的方法来预测入院时的AP严重程度，一开始就促进及时干预。
方法：对转诊医院收治的85名患者进行了一项观察性横断面研究。AP患者分为两组：轻度AP（MAP）和中度/重度AP（MSAP/SAP）。在所有患者入院时和24小时时评估RDW。
结果：在85例AP患者中，55人被诊断为MAP，17人患有MSAP，13人患有SAP。与MAP相比，MSAP/SAP患者的平均血清钙水平明显较低。此外,修改后的马歇尔（MM）得分，急性胰腺炎严重程度的床旁指数（BISAP）指数，RDW在0小时和24小时，MSAP/SAP患者的RDW/血清总钙（RDW/TSC）比值明显高于MAP。BISAP指数，其次是MM,成为最可靠的严重程度预测因子，RDW/TSC也显示出较强的预测价值。与入院时和24小时测量的RDW相比，RDW/TSC对AP严重程度的预测能力更高。然而,没有个体参数被确定为AP的独立显著预测因子.
结论：红细胞分布宽度和RDW/TSC比率与BISAP指数相当，可以预测AP的严重程度。他们提供了一种具有成本效益且易于获得的方法来预测入院时的AP严重程度，一开始就促进及时干预。
