The Value Of Red Blood Cell Distribution Width Combined With Hematocrit In Predicting Acute Pancreatitis

Objective:TO explore the value of Hematocrit(HCT)combined with red blood cell distribution width(RDW)in predicting the severity of acute pancreatitis(AP).Method:A retrospective analysis of 203 AP patients from the Emergency department in our hospital from2019.9 to 2020.9.According to the revised Atlanta classification,the patients were split into mild(MAP)with 80 cases,moderate(MASP)with 76casesand severe(SAP)with 47 cases.Clinical data,including age,gender,HCT,RDW,C-reactive protein(CRP),blood calcium(Ca),glucose(Glu)and Bedside index forseverity in acute pancreatitis(BISAP-score)measured within 24 hours after admission,compare the basic data of the three arms of patients,using multiple Logistics regression analyzed the risk factors of SAP patients,and used ROC curve to study the diagnostic efficacy of RDW combined with HCT in predicting AP.Results:The gender composition and age distribution of the three arms of patients were not statistically significant,P>0.05.There were statistically significant in RDW,HCT,Ca,Glu,CRP,BISAP-score of the three arms(P<0.01),and there were also statistical differences between groups using one-way analysis of variance and rank test analysis.Correlation analysis found that RDW,HCT and CRP,Ca,Glu,BISAP-score were significantly related(r=0.472,r=-0.471,r=0.180,r_s=0.470;r=0.378,r=-0.272,r=0.188,r_s=0.142,)P<0.05,were statistically significant.The RDW and HCT were also significantly correlated(r=0.163,P<0.05).Spearman correlation analysis found that the severity of pancreas was significantly correlated with RDW,HCT,Ca,Glu,CRP,BISAP-score(r_s=0.668,0.424,-0.654,0.419,0.813,0.654,P<0.01).Multivariate ordered Logistics regression analysis indicated that RDW,HCT,Ca,Glu,CRP,BISAP-score were risk factors for SAP patients(P<0.01).the final ROC analysis showed that the BISAP-score predicts the condition of AP patients with an AUC of0.897,AUC of 0.901(95%CI 0.852～0.950,P=0.000),and AUC of RDW alone was0.859(95%CI 0.801～0.917,P<0.05),the AUC of HCT alone was 0.737(95%CI 0.653to 0.822,P<0.01),and the AUC of RDW&HCT combined to predict the condition of AP patients was 0.897(95%CI 0.848 to 0.947,P<0.01).According to the crest value of Youden Index,the best cut-off value RDW was 13.5%,the sensitivity and specificity of diagnosis of SAP were 70%and 88%,and the best cut-off value of HCT was 0.44,and the sensitivity and specificity were 64%.The sensitivity and specificity of the combined diagnosis of HCT and RDW were 85%and 81%.At this time,the best cut-off values of HCT and RDW were(0.411,12.2%)Conclusion:RDW,HCT and the severity of pancreatitis were all significantly positively correlated,the higher the value of the two,the more severe;They were an independent risk factor for SAP patients;RDW combined with HCT can predict the severity of pancreatitis earlier,having certain clinical value.