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Significance and Prognostic Value of Red Blood Cell Distribution as a Severity Index for Patients Diagnosed as Having Acute Pancreatitis.

To the Editor: A cute pancreatitis (AP) is the most common gastrointestinal cause of hospital admission in the United States. For years, researchers have sought out methods to better determine the prognosis of patients with AP. Red blood cell distribution width (RDW) is a routine laboratory test that is obtained as a part of the complete blood count. As such, it is inexpensive and already being obtained in most patients who are admitted to the hospital. In common practice, RDW is assessed to differentiate between causes of anemia, but recently, RDW has been shown to also have potential as an inflammatory biomarker. Several studies have already tested the hypothesis that elevated RDW correlates with severity of AP. In the present study, we sought to confirm the prognostic utility of RDW for patients admitted to the hospital with AP. The total sample size was 489. The sample composition was 53.2% female, and the mean (standard deviation) age was 48.1 (17.4) years. For race/ethnicity, the sample was approximately 46.0% African American, 49.3% white, and 4.7% other. The mortality rate was 9.4%. We conducted several analyses to test the association between RDWand severity. Results showed that RDW was higher among thosewho had an intensive care unit (ICU) visit (mean, 15.4) than among those who did not have an ICU visit (mean, 14.7; t484 = 2.9, P = 0.004). Next, results showed that RDW was associated with higher odds of an ICU admission (odds ratio, 1.15; P = 0.005). We also tested the association between RDWand ICU length of stay (LOS) among those who had an ICU stay. Results from linear regression analysis indicated that the unstandardized regression coefficient was b = 0.70 (P = 0.04), indicating that every 1-point increase in RDW was associated with an increase of approximately 0.7 days in the ICU LOS. The relationships between RDW and other severity indicators were also assessed.