Red Cell Distribution Width with Platelet Count Ratio as a Marker of Severity in Acute Biliary Pancreatitis

Authors

  • Mahlail Hasan Khan Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Uzma Javed Gul Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Khurrum Sarfaraz Bajwa Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Tariq Kamal Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Sajid Ameer Fahim Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Uroosa Din Muhammad Department of Obstetrics & Gynecology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i2.9145

Keywords:

Acute Pancreatitis, Disease Severity, Mortality, Platelet Count Red Cell Distribution Width

Abstract

 

Objective: To evaluate and compare red cell distribution width-to-platelet count ratio (RPR) as marker of severity among patients managed for mild and severe acute biliary pancreatitis.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Apr 2021 to Mar 2022. 

Methodology: Patients were diagnosed with mild or severe acute pancreatitis by using the modified Atlanta criteria: (1) Epigastric pain (2) Increased serum lipase levels, and (3) CT imaging findings indicative of acute pancreatitis. Patients with comorbidities including ischemic heart disease, cerebrovascular accidents, or pregnant females were excluded. The clinical severity of illness was assessed by Ranson and Glasgow scores at the time of admission and at 48 hours. Red cell distribution width-to-platelet count ratio (RPR) values were also assessed at the time of admission. Patient mortality was assessed at 7 days post admission and at 30 days after discharge.

Results: Out of a total of 45 patients, mean age was estimated at 47.6±12.0 years while 20(44%) cases fulfilled the criteria of severe acute pancreatitis. Mean RPR values were significantly increased among patients with severe clinical illness (p<0.001) and among non-surviving cases (p=0.014). Nine (20%) patients died during the 30-day follow-up.

Conclusion: Red cell distribution width-to-platelet count ratio is a substantially efficient parameter in the early diagnosis of severe acute pancreatitis.

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References

Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management. Hepatobiliary Pancreat Dis Int 2017; 16(2): 155-159.

https://doi.org/10.1016/S1499-3872(16)60163-7

Mandalia A, Wamsteker EJ, DiMagno MJ. Recent advances in understanding and managing acute pancreatitis. F1000Res 2018; 7. https://doi.org/10.12688/f1000research.14244.2

Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther 2013; 38(5): 539-548.

https://doi.org/10.1111/apt.12408

Pokras S, Ray M, Zheng S, Ding Y, Chen CC. The Short- and Long-Term Burden of Acute Pancreatitis in the United States: A Retrospective Cohort Study. Pancreas 2021; 50(3): 330-340.

https://doi.org/10.1097/MPA.0000000000001757

Naeem M, Saeed T, Samad A, Waheed MR. Frequency of mortality of patients with acute pancreatitis using bedside index for severity. J Med Sci 2018; 26(2): 15963.

James TW, Crockett SD. Management of acute pancreatitis in the first 72 hours. Curr Opin Gastroenterol 2018; 34(5): 330-335.

https://doi.org/10.1097/MOG.0000000000000456

Wu Q, Wang J, Qin M, Yang H, Liang Z, Tang G. Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study. Lipids Health Dis 2021; 20(1): 41.

https://doi.org/10.1186/s12944-021-01470-4

Venkatesh NR, Vijayakumar C, Balasubramaniyan G, Chinnakkulam S, Sundaramurthi S. Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study. Cureus 2020; 12(2): e6943.

https://doi.org/10.7759/cureus.6943

Goyal H, Awad H, Hu ZD. Prognostic value of admission red blood cell distribution width in acute pancreatitis: a systematic review. Ann Transl Med 2017; 5(17): 342.

https://doi.org/10.21037/atm.2017.06.61

Cetinkaya E, Senol K, Saylam B, Tez M. Red cell distribution width to platelet ratio: new and promising prognostic marker in acute pancreatitis. World J Gastroenterol 2014; 20(39): 14450-14454. https://doi.org/10.3748/wjg.v20.i39.14450

Barad JK, Debata D, Nath VG, Sahoo A, Debata PK, Kar PK, et al. RPR (Red Cell Distribution Width to Platelet Ratio): As a Prognostic Marker in Acute Pancreatitis. J Clin Diagn Res 2019; 13(6).

https://doi.org/10.7860/JCDR/2019/29344.12937

Shrestha B, Dunn L. The declaration of Helsinki on medical research involving human subjects: A review of seventh revision. J Nepal Health Res Counc 2019; 17(4): 548-552.

https://doi.org/10.33314/jnhrc.v17i4.1042

Bujak K, Wasilewski J, Osadnik T, Jonczyk S, Kołodziejska A, Gierlotka M, et al. The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology. Dis Markers 2015; 2015(1): 824624.

https://doi.org/10.1155/2015/824624

Goyal H, Hu ZD. Prognostic value of red blood cell distribution width in hepatocellular carcinoma. Ann Transl Med 2017; 5(13): 271.

https://doi.org/10.21037/atm.2017.06.30

Montagnana M, Danese E. Red cell distribution width and cancer. Ann Transl Med 2016; 4(20): 399.

https://doi.org/10.21037/atm.2016.10.50

O'Connell RM, Boland MR, O'Driscoll J, Salih A, Arumugasamy M, Walsh TN, et al. Red cell distribution width and neutrophil to lymphocyte ratio as predictors of outcomes in acute pancreatitis: A retrospective cohort study. Int J Surg 2018; 55(1): 124-127.

https://doi.org/10.1016/j.ijsu.2018.05.028

Zhang FX, Li ZL, Zhang ZD, Ma XC. Prognostic value of red blood cell distribution width for severe acute pancreatitis. World J Gastroenterol 2019; 25(32): 4739-4748.

https://doi.org/10.3748/wjg.v25.i32.4739

Kılıç M, Çelik C, Yüksel C, Yıldız BD, Tez M. Correlation between Ranson score and red cell distribution width in acute pancreatitis. Ulus Travma Acil Cerrahi Derg 2017; 23(2): 1126.

https://dx.doi.org/10.5505/tjtes.2016.27895

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Published

29-04-2025

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Original Articles

How to Cite

1.
Khan MH, Gul UJ, Bajwa KS, Kamal T, Fahim SA, Muhammad UD. Red Cell Distribution Width with Platelet Count Ratio as a Marker of Severity in Acute Biliary Pancreatitis. Pak Armed Forces Med J [Internet]. 2025 Apr. 29 [cited 2025 May 1];75(2):254-7. Available from: https://pafmj.org/PAFMJ/article/view/9145