The Predictive Value of Red Cell Distribution Width for the Risk of Sepsis in Patients with Acute Pancreatitis: A Retrospective Cohort Study.

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pancreas Pub Date : 2025-07-01 DOI:10.1097/MPA.0000000000002475

Chao Yang, Haijun Cao, Shanshan Chen, Cheng Ye, Zemin Feng, Haochen Zhang, Li Xu

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Abstract

Objectives: This study was to evaluate the association between red cell distribution width (RDW) and sepsis in acute pancreatitis (AP) patients, and assess its predictive value for sepsis in AP patients.

Methods: This retrospective cohort study collected patients' data from the Medical Information Mart for Intensive Care databases. Univariate and multivariate Cox models were exploited to compare the mortality within 30 days in AP patients with or without sepsis, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Univariate and multivariate logistic regression analyses were conducted to estimate the association, with odds ratios (ORs) and 95%CIs calculated. The predictive value of RDW, white blood cell (WBC) sequential organ failure assessment (SOFA), SOFA+RDW, simplified acute physiology score II (SAPSII), SAPSII+RDW, bedside index of severity in acute pancreatitis (BISAP), BISAP+RDW for sepsis risk in patients with AP were evaluated by receiver operating characteristic (ROC) curve.

Results: A total of 327 AP patients developed sepsis. The high RDW level was linked to a higher sepsis risk in patients with AP, carrying a (95% CI) of 1.10. Delong test showed that the area under the curve (AUC) of SOFA+RDW, SAPSII+RDW and BISAP+RDW scoring models were significantly greater than those of SOFA, SAPSII and BISAP scoring models, respectively (0.822 vs 0.776; 0.708 vs 0.688; 0.609 vs 0.550, respectively).

Conclusion: RDW is not only linked to sepsis risk, but also has a certain additive effect on SOFA, SAPSII and BISAP models, among which SOFA+RDW has the highest discrimination capacity for sepsis in AP patients.

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红细胞分布宽度对急性胰腺炎患者脓毒症风险的预测价值：一项回顾性队列研究

目的：本研究旨在评价红细胞分布宽度（RDW）与急性胰腺炎（AP）患者脓毒症的关系，并评估其对AP患者脓毒症的预测价值。方法：本回顾性队列研究从重症监护医学信息市场数据库中收集患者资料。采用单因素和多因素Cox模型比较伴有或不伴有败血症的AP患者30天内的死亡率，并计算危险比（hr）和95%置信区间（CIs）。进行单因素和多因素logistic回归分析来估计相关性，并计算优势比（or）和95% ci。采用受试者工作特征（ROC）曲线评价RDW、白细胞（WBC）顺序器官衰竭评估（SOFA）、SOFA+RDW、简化急性生理评分II （SAPSII）、SAPSII+RDW、急性胰腺炎床边严重程度指数（BISAP）、BISAP+RDW对AP患者脓毒症风险的预测价值。结果：共有327例AP患者发生败血症。高RDW水平与AP患者较高的脓毒症风险相关，95% CI为1.10。Delong检验表明，SOFA+RDW、SAPSII+RDW和BISAP+RDW评分模型的曲线下面积（AUC）分别显著大于SOFA、SAPSII和BISAP评分模型(0.822 vs 0.776；0.708 vs 0.688；分别为0.609 vs 0.550)。结论：RDW不仅与脓毒症风险相关，而且对SOFA、SAPSII和BISAP模型均有一定的加性作用，其中SOFA+RDW对AP患者脓毒症的鉴别能力最高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.