http://www.scirp.org/journal/ojgas
ISSN Online: 2163-9469
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.