Abstract

Although acute pancreatitis is a common emergency, accurately anticipating of patients with severe illness was difficult. Haematological prognostic markers like red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) may be useful. Objective of this study was to explore the validity of NLR & RDW in anticipating the outcome of patients with acute pancreatitis, as well as to find out the appropriate cut-off levels which allow patients to be classified into mild (MAP) and severe acute pancreatitis (SAP) groups within the first 48 hours of hospital admission. Materials and Methods: All patients who visit to the emergency department with acute pancreatitis, studied their clinical, imaging, length of stay and haematological parameters, including RDW and NLR. Sensitivity, Specificity and the optimal cut-off value of NLR and RDW were used to assess diagnostic accuracy. Results: The study included 40 patients having acute pancreatitis, of which 21 (52.5%) had an increased RDW (above the upper limit of normal) and 32 (80%) had an increased NLR. The average length of stay in these patients was apparently longer (10.5 vs. 8.5 days; p = 0.01). 21 (52.5%) cases who had both a raised RDW and a raised NLR had an increased risk. Four cases of ICU admissions (10%) with the mean length of hospital stay of 9.6 days were recorded. Conclusion: RDW and NLR can identify patients who are at high risk of developing severe acute pancreatitis. Acute pancreatitis presented with raised RDW and NLR on the day of admission are independent individual predictors of the need for ICU admission and both NLR and RDW are directly proportional to duration of hospital stay.

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