Combination of Red Cell Distribution Width, Plasma Albumin, and Serum Amylase as Marker of Severity of Infection in Emergency Patients with Acute Pancreatitis.

Abstract

Background: This study aimed to investigate the predictive values of red cell distribution width (RDW), plasma albumin (ALB), and serum amylase (AMY) for the occurrence of infection in emergency patients with acute pancreatitis (AP) as well as their correlations with the severity.

Methods: A total of 121 AP patients with infection and 137 without infection treated between January 2022 and January 2024 were enrolled as infection group and non-infection group, respectively. The infection group was further assigned into a good prognosis group (n = 65) and a poor prognosis group (n = 56). Venous blood (4 mL) was collected in the morning after at least 8 hours of fasting. RDW, plasma ALB level, and serum AMY level were measured through blood cell analysis, enzyme-linked immunosorbent assay, and rate method, respectively.

Results: RDW and serum AMY level were positively correlated with computed tomography severity index (CTSI) score, whereas plasma ALB level was negatively correlated with CTSI score (p < 0.05). RDW and serum AMY were independent risk factors for infection in emergency AP patients, and plasma ALB was an independent pro¬tective factor (p < 0.05). The areas under the receiver operating characteristic curves (AUCs) of RDW, plasma ALB, and serum AMY levels for predicting infection in AP patients reached 0.794, 0.770, and 0.812, respectively, while the AUC, sensitivity, and specificity of their combination were 0.907, 86.86%, and 80.99%, respectively.

Conclusions: RDW, plasma ALB, and serum AMY were abnormally expressed in AP patients with infection, and they all had significant correlations with the severity. The combined detection of the three indicators had the highest predictive value.