Abstract
Background/Purpose: Early assessment of the severity of acute pancreatitis (AP) is a highly challenge for a physicians’ practice to improve the management and decrease the mortality. We aimed to determine early prognostic factors for AP related in-hospital mortality. Methods: Upon hospital admission, predictors of AP related in-hospital mortality were prospectively assessed using regression analysis over 129 consecutive AP patients. Predictive abilities of these prognostic factors were compared using the area under receiver operating characteristic curve (AUC). Results: AP related in-hospital mortality was 10.9%. Red cell distribution (RDW), serum creatinine, glucose and albumin were associated with AP mortality. RDW had the highest AUC followed by serum creatinine and albumin (AUC: 914, 95% CI: 0.797 - 0.975; 0.797, 95% CI: 0.695 - 0.878; 0.798, 95% CI: 0.677 - 0.865 respectively). The cut-off with the best ability to predict in-hospital mortality was 14.2 for RDW. By coupling RDW and serum creatinine, AUC was improved to 0.940, 95% CI: 0.839 - 0.986. Conclusion: RDW, serum creatinine, albumin, and glucose even with borderline level changes may predict AP related in-hospital mortality, where, RDW has the highest prognostic accuracy. Coupling RDW and serum creatinine model significantly improves their predictive accuracy that may aid in further improvement of the quality of care of AP patients.
Highlights
Acute inflammation of the pancreas (AP) has a wide spectrum of severity
Blood samples were collected for laboratory investigations, and included: complete blood count including white blood cells (WBC), hemoglobin (Hb), platelets (PLT) and red cell distribution width (RDW), liver function tests, kidney function tests including serum creatinine and blood urea nitrogen (BUN), serum sodium, serum calcium, serum potassium, serum glucose, C-reactive protein (CRP) and lactate dehydrogenase (LDH), and arterial blood gas analysis
We examined the effectiveness of RDW, serum glucose, creatinine and albumin in prediction of acute pancreatitis (AP) related in-hospital mortality using receiver operating characteristic (ROC) analysis
Summary
Several prognostic scoring systems have been proposed for that issue; it may take longer time for observation i.e. after 48 hours as Ranson’s criteria [7], or its use is complex as The Acute Physiology And Chronic Health Evaluation II (APACHE II) scoring system [8]. Whereas, laboratory indexes such as IL-6, CRP, serum lipase and amylase, easy feasibility, but their results have been inconsistent and unrelated to the disease severity [9]. The presence of sensitive, easy available and inexpensive laboratory markers for predicting the early AP mortality is recommended
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