Donmez Mustafa, Ayata Orhan
General Surgery, Ankara Bilkent City Hospital, Ankara, TUR.
General Surgery, Ankara Yildirim Beyazit University, Ankara, TUR.
Cureus. 2022 Oct 11;14(10):e30183. doi: 10.7759/cureus.30183. eCollection 2022 Oct.
Objective Acute pancreatitis (AP) is a common inflammatory disease that should be considered in the etiology of patients presenting to the emergency department with abdominal pain. AP manifests with a clinical picture that can lead to organ failure and even death; therefore, early diagnosis and treatment are essential. In this study, we aimed to evaluate the red cell distribution width (RDW)/albumin ratio (RAR), which, we consider, can be used to determine the clinical course of acute biliary pancreatitis (ABP). Material and method The study included 166 patients with ABP. The patient's demographic information, blood values at the time of the first presentation to the emergency department, and radiological results were recorded by screening them retrospectively. Using the Atlanta criteria, the cases were classified into mild, moderately severe, and severe AP groups (MAP, MSAP, and SAP, respectively) and compared. Results Of the patients, 121 (72.9%) patients had MAP, 40 (24.1%) had MSAP, and five (3%) had SAP. There was no statistically significant difference between the three groups regarding gender and age. The SAP group had significantly higher median values for the length of hospital stay [19 (4-31) days], white blood cell (WBC) count [20.4 x10/L (9.1-23.3 x10/L)], and creatinine (Cre) [1.4 mg/dL (0.7-3.4 mg/dL)] (p<0.001, p=0.003, and p=0.014, respectively). The RDW and albumin values of all the groups were within normal ranges. RAR was higher in the SAP group but did not statistically significantly different between the groups. In the receiver operating characteristic (ROC) analysis of RAR, the area under the curve (AUC) value was determined as 0.75, sensitivity as 80%, specificity as 70.2%, and positive likelihood ratio as 2.1 (p=0.05). Conclusion It is considered that RAR may be a helpful method in determining the course of ABP attacks, but there is a need for studies with a larger series, including all pancreatitis cases.
目的 急性胰腺炎(AP)是一种常见的炎症性疾病,对于因腹痛就诊于急诊科的患者,其病因应予以考虑。AP的临床表现可能导致器官衰竭甚至死亡;因此,早期诊断和治疗至关重要。在本研究中,我们旨在评估红细胞分布宽度(RDW)/白蛋白比值(RAR),我们认为该比值可用于确定急性胆源性胰腺炎(ABP)的临床病程。
材料与方法 本研究纳入了166例ABP患者。通过回顾性筛查记录患者的人口统计学信息、首次就诊于急诊科时的血液值以及放射学结果。根据亚特兰大标准,将病例分为轻度、中度重症和重症AP组(分别为MAP、MSAP和SAP)并进行比较。
结果 患者中,121例(72.9%)为MAP,40例(24.1%)为MSAP,5例(3%)为SAP。三组在性别和年龄方面无统计学显著差异。SAP组的住院时间中位数[19(4 - 31)天]、白细胞(WBC)计数[20.4×10⁹/L(9.1 - 23.3×10⁹/L)]和肌酐(Cre)[1.4mg/dL(0.7 - 3.4mg/dL)]显著更高(分别为p<0.001、p = 0.003和p = 0.014)。所有组的RDW和白蛋白值均在正常范围内。RAR在SAP组中较高,但组间无统计学显著差异。在RAR的受试者工作特征(ROC)分析中,曲线下面积(AUC)值确定为0.75,灵敏度为80%,特异度为70.2%,阳性似然比为2.1(p = 0.05)。
结论 认为RAR可能是确定ABP发作病程的一种有用方法,但需要开展包括所有胰腺炎病例的更大样本量研究。