THE PROGNOSTIC SIGNIFICANCE OF RED CELL DISTRIBUTION WIDTH (RDW) AND NEUTROPHIL-LYMPHOCYTE RATIO (NLR) IN ACUTE PANCREATITIS

Abstract

Background: Hematological prognostic markers like red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) may be useful. The purpose of this study was to explore the validity of NLR & RDW in anticipating the outcome of patients with acute pancreatitis, as well as to nd out the appropriate cut-off levels which allow patients to be classied into mild (MAP) and severe acute pancreatitis (SAP) groups within the rst 48 hours of hospital admission. All patients who visit to the Methods: emergency department with acute pancreatitis, studied their clinical, imaging, length of stay, and hematological parameters, including RDW and NLR. Sensitivity, Specicity, and the optimal cut off value of NLR and RDW were used to assess diagnostic accuracy. The study Results: included 40 patients having acute pancreatitis, of which 21 (52.5 %) had an increased RDW, and 32 (80 %) had an increased NLR. The average length of stay in these patients was apparently longer (10.5 v 8.5 days; p = 0.01). 21 (52.5%) cases who had both a raised RDW and a raised NLR had an increased risk. No deaths noted in the study. Four cases of ICU admissions (10%) with the mean length of hospital stay of 9.6 days were recorded. An AUC of 0.63& 0.755for RDW and NLR respectively in anticipating the requiring for intensive care admission. For the patient to be admitted in to critical care, the optimal cut off for RDW is 14.65 %, with a sensitivity value of 46.70% and a specicity value of 80.0%, while RDW had cutoff of 15.5, with sensitivity value of 33 % and a specicity value of 89.40%. The optimal value for NLR cut off for admission into intensive care unit (ICU) was 8.01, with sensitivity value of 86.70% and specicity value of 64.70%, while an NLR value of 5 and over had a sensitivity value of 93.30% and a specicity value of 39.40%. Acute pancreatitis pre Conclusions: sented with an raised RDW and NLR on the day of admission are independent individual predictors of the need for ICU admission. Patients with acute pancreatitis who have high RDW and NLR on admission have a higher risk of a longer hospital stay