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Early Predictors of Acute Pancreatitis Related In-Hospital Mortality: How Practical Are They?

Open Journal of Gastroenterology 2018年第3期8卷 67-78页

作者： Elham Ahmed Hassan Abeer Sharaf El-Din Abdel Rehim mohammad alyamany kobeisy Ahmed Mohammed Ashmawy Zain El-Abdeen Ahmed Sayed Raed Salah Ameen Department of Tropical Medicine and Gastroenterology Faculty of Medicine Assiut University Assiut Egypt Department of Internal Medicine Faculty of Medicine Assiut University Assiut Egypt

Background/Purpose: Early assessment of the severity of acute pancreatitis (AP) is a highly challenge for a physicians’ practice to improve the management and decrease the mortality. We aimed to determine early prognostic factors for AP related in-hospital mortality. Methods: Upon hospital admission, predictors of AP related in-hospital mortality were prospectively assessed using regression analysis over 129 consecutive AP patients. Predictive abilities of these prognostic factors were compared using the area under receiver operating characteristic curve (AUC). Results: AP related in-hospital mortality was 10.9%. Red cell distribution (RDW), serum creatinine, glucose and albumin were associated with AP mortality. RDW had the highest AUC followed by serum creatinine and albumin (AUC: 914, 95% CI: 0.797 - 0.975;0.797, 95% CI: 0.695 - 0.878;0.798, 95% CI: 0.677 - 0.865 respectively). The cut-off with the best ability to predict in-hospital mortality was 14.2 for RDW. By coupling RDW and serum creatinine, AUC was improved to 0.940, 95% CI: 0.839 - 0.986. Conclusion: RDW, serum creatinine, albumin, and glucose even with borderline level changes may predict AP related in-hospital mortality, where, RDW has the highest prognostic accuracy. Coupling RDW and serum creatinine model significantly improves their predictive accuracy that may aid in further improvement of the quality of care of AP patients.

关键词： Acute Pancreatitis In-Hospital Mortality Red Cell Distribution Width

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