Red Cell Distribution Width and RDW/TSC Ratio may Effectively Predict Acute Pancreatitis Severity: Study

India: An observational cross-sectional study demonstrates red cell distribution width and RDW/TSC ratio are similar to the BISAP index as predictors of severity in acute pancreatitis. The findings were published online in The Journal of The Associations of Physicians of India on July 01, 2024.

Acute pancreatitis occurs when the pancreas becomes inflamed (swollen) for a short amount of time. It involves acute pancreatic inflammation. The most prevalent causes of acute pancreatitis include gallstones, alcohol consumption, and hypertriglyceridemia. Symptoms may include fever, nausea, vomiting, rapid heartbeat, and a bloated or painful abdomen. Chiranth Shivakumar, Post Graduate Resident, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India, et.al conducted an observational cross-sectional study to investigate red cell distribution width and RDW/TSC ratio and are comparable to the BISAP index as predictors of severity in acute pancreatitis.

For this purpose, the research team conducted observational cross-sectional research of 85 patients admitted to the medicine and surgical wards at VMMC and Safdarjung Hospital in Delhi undertaken between December 2020 and June 2022. A history was taken, a clinical examination was performed, and appropriate diagnostic tests were ordered.

The study comprised 85 patients over the age of 18 who had been diagnosed with acute pancreatitis using the new Atlanta classification. Then they divided into two groups. Those with mild acute pancreatitis (MAP) and moderately severe/severe acute pancreatitis AP (MSAP/SAP). Red cell distribution width was measured in all patients upon admission and at the 24-hour mark.

The findings revealed that:

• Of the 85 AP patients, 55 were diagnosed with MAP, 17 with MSAP and 13 with SAP.
• MSAP/SAP patients had significantly lower serum calcium levels compared to MAP patients.
• Patients with MSAP/SAP had significantly higher modified Marshall (MM) scores, bedside index for severity in acute pancreatitis (BISAP) index, RDW at 0 and 24 hours, and RDW/total serum calcium (RDW/TSC) ratios compared to MAP.
• The BISAP index was shown to be the most reliable predictor of severity, followed by MM. RDW/TSC also demonstrated good predictive value.
• RDW/TSC outperformed RDW at admission and 24 hours in terms of predicting AP severity. However, no single parameter has been established as an independent meaningful predictor of AP.

“Red cell distribution width and RDW/TSC ratio are as good predictors of AP severity as the BISAP index is. They provide a low-cost and easily accessible method of forecasting AP severity at the time of admission, allowing for early intervention”, researchers concluded.

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