Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Dec 20, 2023; 13(5): 115-122
Published online Dec 20, 2023. doi: 10.5493/wjem.v13.i5.115
Red cell distribution width: A predictor of the severity of hypertriglyceridemia-induced acute pancreatitis
Yong-Cai Lv, Yan-Hua Yao, Juan Zhang, Yu-Jie Wang, Jing-Jing Lei
Yong-Cai Lv, Department of Gastroenterology, Zhenning Buyi and Miao Autonomous County People’s Hospital, Zhenning 561200, Guizhou Province, China
Yan-Hua Yao, Juan Zhang, Yu-Jie Wang, Department of Gastroenterology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550014, Guizhou Province, China
Jing-Jing Lei, Department of Geriatric Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550014, Guizhou Province, China
Author contributions: Lv YC and Lei JJ designed the study; Lv YC, Yao YH, Zhang J, and Wang YJ, participated in the acquisition, analysis, and interpretation of the data; Lv YC wrote the manuscript; Lei JJ revised the article.
Supported by the Science and Technology Program of Guiyang Baiyun District Science and Technology Bureau. No. [2017] 50; Science and Technology Program of Guiyang Municipal Bureau of Science and Technology, No. [2018] 1-72; and Science and Technology Fund Project of Guizhou Provincial Health Commission, No. gzwkj2021-127.
Institutional review board statement: This study was reviewed and approved by the Science and Research Office of the Affiliated Baiyun Hospital of Guizhou Medical University.
Informed consent statement: Patients’ consent for inclusion was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Jing Lei, PhD, Doctor, Department of Geriatric Medicine, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, Guiyang 550004, Guizhou Province, China. lycyyh0325@163.com
Received: August 31, 2023
Peer-review started: August 31, 2023
First decision: October 9, 2023
Revised: October 19, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: December 20, 2023
Processing time: 109 Days and 15 Hours
Abstract
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.

AIM

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.

CONCLUSION

RDW is a promising predictor of POF in patients with HTG-AP, and the addition of RDW can promote the sensitivity of BISAP.

Keywords: Red cell distribution width; Bedside index for severity in acute pancreatitis; Persistent organ failure; Hypertriglyceridemia-induced acute pancreatitis

Core Tip: Red cell distribution width (RDW) reflects systemic inflammation, which is significantly associated with the severity of acute pancreatitis. However, the relationship between RDW and hypertriglyceridemia-induced acute pancreatitis (HTG-AP) remains unclear. Herein, RDW exhibited a potent discriminatory power for predicting persistent organ failure in patients with HTG-AP. Furthermore, the addition of RDW is able to promote the sensitivity of bedside index for severity in acute pancreatitis.