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

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.