Hussaini Helai, Obeidat Kinan, Maali Abusal Abdelaziz, Fadeyi Olaniyi, Habib Ihtisham, Chaudhari Sandipkumar S, Wei Calvin R, Hirani Shamsha
Internal Medicine, West Anaheim Medical Center, Anaheim, USA.
Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus. 2025 Mar 27;17(3):e81279. doi: 10.7759/cureus.81279. eCollection 2025 Mar.
Acute pancreatitis is a potentially life-threatening inflammatory condition with variable clinical presentations. Early risk stratification remains challenging despite existing scoring systems. The red blood cell distribution width-to-albumin ratio (RAR) has emerged as a potential prognostic biomarker in inflammatory conditions. This systematic review and meta-analysis aimed to evaluate the association between admission RAR and outcomes in acute pancreatitis. We conducted a comprehensive literature search and identified five retrospective studies meeting the inclusion criteria. Meta-analysis was performed to assess the relationship between RAR and mortality as well as disease severity in acute pancreatitis patients. Pooled analysis demonstrated that elevated RAR was significantly associated with increased mortality risk (risk ratio (RR): 2.11, 95% confidence interval (95% CI): 1.35-3.30) with moderate heterogeneity (I²: 46%). When comparing disease severity, mean RAR values were significantly lower in mild acute pancreatitis compared to severe cases (mean difference (MD): -1.78, 95% CI: -2.09 to -1.46), also with moderate heterogeneity (I²: 44%). This meta-analysis suggests that RAR, a simple and cost-effective biomarker available from routine blood tests, may serve as a valuable prognostic indicator for mortality and severity in acute pancreatitis. Despite having comparatively lower discriminative ability than conventional scoring systems, RAR offers advantages in terms of rapid assessment and cost efficiency. However, limitations include the small number of included studies, their retrospective nature, and heterogeneity in study settings. Further prospective studies are warranted to validate these findings.
急性胰腺炎是一种具有潜在生命威胁的炎症性疾病，临床表现多样。尽管现有评分系统，但早期风险分层仍然具有挑战性。红细胞分布宽度与白蛋白比值（RAR）已成为炎症性疾病中一种潜在的预后生物标志物。本系统评价和荟萃分析旨在评估急性胰腺炎入院时RAR与预后之间的关联。我们进行了全面的文献检索，确定了五项符合纳入标准的回顾性研究。进行荟萃分析以评估RAR与急性胰腺炎患者死亡率以及疾病严重程度之间的关系。汇总分析表明，RAR升高与死亡风险增加显著相关（风险比（RR）：2.11，95%置信区间（95%CI）：1.35 - 3.30），具有中度异质性（I²：46%）。在比较疾病严重程度时，轻度急性胰腺炎的平均RAR值显著低于重度病例（平均差值（MD）：-1.78，95%CI：-2.09至-1.46），也具有中度异质性（I²：44%）。这项荟萃分析表明，RAR是一种可从常规血液检查中获得的简单且具有成本效益的生物标志物，可能作为急性胰腺炎死亡率和严重程度的有价值的预后指标。尽管RAR的鉴别能力比传统评分系统相对较低，但它在快速评估和成本效益方面具有优势。然而，局限性包括纳入研究数量少、研究的回顾性性质以及研究背景的异质性。需要进一步的前瞻性研究来验证这些发现。
