背景:与其他原因引起急性胰腺炎的患者相比,高甘油三酯血症诱导的急性胰腺炎(HTG-AP)患者更有可能发生持续性器官衰竭(POF).因此,在HTG-AP过程早期认识到有发展POF风险的个体对于改善结果至关重要.急性胰腺炎严重程度的床边指数(BISAP),入院后24小时获得的简单参数,是预测HTG-AP严重程度的理想指标;然而,次优的灵敏度限制了其临床应用。因此,目前的临床评分系统和生化参数不足以预测HTG-AP的严重程度.
目的:阐明红细胞分布宽度(RDW)对HTG-AP中POF的早期预测价值。
方法:总共,回顾性研究102例HTG-AP患者。人口统计学和临床数据,包括RDW,在入院时从所有患者中收集。
结果:基于修订后的亚特兰大分类,102例HTG-AP患者中有37例(33%)被诊断为POF。一入场,患有HTG-AP和POF的患者的RDW明显高于没有POF的患者(14.4%vs12.5%,P<0.001)。接收器工作特性曲线表明,对于POF,RDW具有良好的判别能力,截止值为13.1%,其中曲线下面积(AUC),灵敏度,特异性为0.85,82.4%,77.9%,分别。当RDW≥13.1%并在原始BISAP上加1分以获得新的BISAP分数时,我们获得了更高的AUC,灵敏度,特异性为0.89,91.2%,和67.6%,分别。
结论:RDW是HTG-AP患者POF的一个有希望的预测指标,添加RDW可以提高BISAP的敏感性。
BACKGROUND: Compared with patients with other causes of acute pancreatitis, those with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are more likely to develop persistent organ failure (POF). Therefore, recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes. Bedside index for severity in acute pancreatitis (BISAP), a simple parameter that is obtained 24 h after admission, is an ideal index to predict HTG-AP severity; however, the suboptimal sensitivity limits its clinical application. Hence, current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.
OBJECTIVE: To elucidate the early predictive value of red cell distribution width (RDW) for POF in HTG-AP.
METHODS: In total, 102 patients with HTG-AP were retrospectively enrolled. Demographic and clinical data, including RDW, were collected from all patients on admission.
RESULTS: Based on the Revised Atlanta Classification, 37 (33%) of 102 patients with HTG-AP were diagnosed with POF. On admission, RDW was significantly higher in patients with HTG-AP and POF than in those without POF (14.4% vs 12.5%, P < 0.001). The receiver operating characteristic curve demonstrated a good discriminative power of RDW for POF with a cutoff of 13.1%, where the area under the curve (AUC), sensitivity, and specificity were 0.85, 82.4%, and 77.9%, respectively. When the RDW was ≥ 13.1% and one point was added to the original BISAP to obtain a new BISAP score, we achieved a higher AUC, sensitivity, and specificity of 0.89, 91.2%, and 67.6%, respectively.
CONCLUSIONS: RDW is a promising predictor of POF in patients with HTG-AP, and the addition of RDW can promote the sensitivity of BISAP.