Akut pankreatitte Ranson skoru ile eritrosit daðýlým hacmi arasýndaki korelasyon

AMAÇ: Ranson kriterleri akut pankreatit (AP) þiddetini deðerlendirmek için yaygýn olarak kullanýlýr. Eritrosit daðýlým geniþliði (RDW) de bu gibi hastalarda mortaliteyi öngörmede yararlý bir belirteç olarak gösterilmiþtir. Amaç, AP hastalarýnda Ranson skoru ile RDW arasýndaki iliþkiyi araþtýrmaktýr.
GEREÇ VE YÖNTEM: Toplam 202 AP hastasý çalýþmaya alýndý. Hastalar, 48 saatten uzun süren organ yetersizliði ve/veya lokal komplikasyon varlýðýna baðlý olarak, hafif ve þiddetli AP olarak sýnýflandýrýldý.
BULGULAR: Kýrk hastaya (%19.8) þiddetli AP tanýsý kondu. Þiddetli AP’nin belirlenmesinde, baþlangýç RDW ve Ranson skorlarý için hesaplanan ROC eðrisinde yüksek duyarlýlýk ve özgüllük deðerleri elde edildi. Ranson skoru için 4’ten büyük deðerler, RDW için %14 deðeri cutoff deðerler olarak belirlendi. Baþvuru anýndaki RDW deðerinin 48. saat Ranson skoru ile korele olduðu saptandý (r=0.22, p<0.002). Ancak, 0. günde, RDW ile 0. saat Ranson skoru arasýnda korelasyon yoktu (r=0.07, p=0.600).
TARTIÞMA: Akut pankreatit þiddetini deðerlendirmede tek bir ideal yöntem olmasa da, baþvuru anýndaki RDW seviyesi, birden çoklu skorlama sistemlerinin dezavantajlarý dikkate alýndýðýnda, özellikle birinci basamak saðlýk merkezlerinde, AP þiddetinin erken tahmininde yararlý olabilir.

Correlation between Ranson score and red cell distribution width in acute pancreatitis

BACKGROUND: Ranson’s criteria are widely used to evaluate severity of acute pancreatitis (AP). Red blood cell distribution width (RDW) has been demonstrated to be useful marker to predict mortality in these patients. The aim of the present study was to investigate correlation between Ranson score and RDW in patients with AP.
METHODS: Total of 202 patients with AP were included in the study. Patients were classified as mild or severe AP, based on presence of organ failure for more than 48 hours and/or local complications.
RESULTS: Forty patients (19.8%) were diagnosed as severe AP. High sensitivity and specificity values were obtained from receiver operating characteristic curve for initial RDW and Ranson score in predicting severe AP. Ranson ≥4 was selected cut-off value for Ranson score and 14% was limit for RDW. RDW at time of admission was correlated with 48-hour Ranson score (r=0.22; p<0.002). However, at day 0, there was no correlation between RDW and 0-hour Ranson score (r=0.07; p=0.600).
CONCLUSION: Although there is no single, ideal method to assess severity of AP, RDW level at admission can be helpful in earlier prediction of AP severity, especially in first-line centers, taking into consideration disadvantages of multifactorial scoring systems.