Kılıç Murat Özgür, Çelik Canbert, Yüksel Cemil, Yıldız Barış Doğu, Tez Mesut
Department of General Surgery, Numune Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2017 Mar;23(2):112-116. doi: 10.5505/tjtes.2016.27895.
Ranson's criteria are widely used to evaluate severity of acute pancreatitis (AP). Red blood cell distribution width (RDW) has been demonstrated to be useful marker to predict mortality in these patients. The aim of the present study was to investigate correlation between Ranson score and RDW in patients with AP.
Total of 202 patients with AP were included in the study. Patients were classified as mild or severe AP, based on presence of organ failure for more than 48 hours and/or local complications.
Forty patients (19.8%) were diagnosed as severe AP. High sensitivity and specificity values were obtained from receiver operating characteristic curve for initial RDW and Ranson score in predicting severe AP. Ranson ≥4 was selected cut-off value for Ranson score and 14% was limit for RDW. RDW at time of admission was correlated with 48-hour Ranson score (r=0.22; p<0.002). However, at day 0, there was no correlation between RDW and 0-hour Ranson score (r=0.07; p=0.600).
Although there is no single, ideal method to assess severity of AP, RDW level at admission can be helpful in earlier prediction of AP severity, especially in first-line centers, taking into consideration disadvantages of multifactorial scoring systems.
兰森标准被广泛用于评估急性胰腺炎(AP)的严重程度。红细胞分布宽度(RDW)已被证明是预测这些患者死亡率的有用指标。本研究的目的是探讨AP患者兰森评分与RDW之间的相关性。
本研究共纳入202例AP患者。根据是否存在超过48小时的器官衰竭和/或局部并发症,将患者分为轻度或重度AP。
40例(19.8%)患者被诊断为重度AP。在预测重度AP时,初始RDW和兰森评分的受试者工作特征曲线获得了较高的敏感性和特异性值。兰森评分的截断值选择为兰森≥4,RDW的限值为14%。入院时的RDW与48小时兰森评分相关(r=0.22;p<0.002)。然而,在第0天,RDW与0小时兰森评分之间无相关性(r=0.07;p=0.600)。
尽管没有单一的理想方法来评估AP的严重程度,但考虑到多因素评分系统的缺点,入院时的RDW水平有助于早期预测AP的严重程度,尤其是在一线中心。