Öz
Amaç: Akut pankreatit (AP) tanısıyla hastaneye yatırılan hastalarda yatıştan itibaren hastalığın şiddetini belirlemek tedavinin planlaması için büyük önem arz etmektedir. RDW (Eritrosit Dağılım Hacmi) ve MPV’nin (Ortalama Trombosit Hacmi) pankreatitin şiddetini öngörebilme özelliğinin olup olmadığını araştırmak amacıyla bu çalışmayı yaptık.
Materyal ve metod: 2019-2022 yılları arasında AP nedeniyle hastaneye yatırılan 262 hastanın verileri retrospektif olarak incelendi. Hastalar Atlanta kriterleri referans alınarak pankreatitin şiddetine göre gruplara ayrıldı. Daha sonra RDW ve MPV değerlerinin pankreatitin şiddeti ve prognozuyla ilişkisi istatistiksel olarak incelendi.
Bulgular: AP’li hastaların %83.9’u (n=220) hafif; %16.1’i (n=42) şiddetli pankreatit idi. Ortalama RDW indeksi hafif AP’li hastalarda 42.5±6.9 fL iken, şiddetli AP hastalarında 42.0±6.6 fL idi (p=0.625). Ortalama MPV seviyesi açısından da her iki grup arasında anlamlı bir farklılık saptanmadı (9.7±1.0 fL vs 9.8±1.3 Fl, p=0.687). Yapılan ROC analizi pankreatitin şiddetini saptayacak anlamlı ve kritik bir MPV ve RDW eşik değerinin olmadığını gösterdi (AUC (MPV): 0.499; AUC (RDW):0.453).
Sonuç: AP nedeniyle hastaneye yatırılan ve takipleri sırasında Atlanta kriterlerine göre şiddetli pankreatit gelişen hastaların RDW ve MPV seviyesinin hafif pankreatitli hastalardan farklı olmadığını belirledik. AP’li hastalarda MPV ve RDW seviyesinin pankreatitin şiddetini ve prognozunu öngörmede yeterli ve güçlü bir parametre olmadığını söyleyebiliriz.
Anahtar Kelimeler
Akut Pankreatit Eritrosit Dağılım Genişliği (RDW) Ortalama Trombosit Hacmi (MPV)
Etik Beyan
Bu çalışma, Gazi Yaşargil Eğitim ve Araştırma Hastanesi klinik Araştırmalar Etik Kurulu tarafından 25.11.2022 tarih ve 228 karar sayısı ile onaylanmıştır.
Teşekkür
Bu çalışmayı destekleyen tüm katılımcılara teşekkür ederiz.
Kaynakça
- 1. Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute panc-reatitis. Lancet. 2020;396(10252):726-734.
- 2. Ugur Fahri Y, Esat Taylan U. Akut Pankreatitte Tiyol Disülfit Homeostazı Hastalık Lehine Bozulmaktadır. Dicle Tıp Dergisi / Dicle Med J 2023;50(3):391-397,
- 3. Venkatesh NR, Vijayakumar C, Balasubramaniyan G, et al. Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study. Cureus. 2020;12(2):e6943.
- 4. Constantino B. Red cell distribution width, revisi-ted. Laboratory Medicine. 2013;44(2):e2-e9.
- 5. Sargent S. Pathophysiology, diagnosis and management of acute pancreatitis. Br J Nurs. 2006;15(18):999-1005.
- 6. Kara H, Doğru A, Değirmenci S, et al. Diagnostic value of neutrophil-to-lymphocyte ratio in emergency department pa-tients diagnosed with acute pancreatitis. Cukurova Medical Journal. 2016;41(1):55-60.
- 7. Feng GH, Li HP, Li QL. et al. Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol. 2017;2(3):172-175.
- 8. Lippi G, Turcato G, Cervellin G et al. Red blood cell distribu-tion width in heart failure: A narrative review. World J Car-diol. 2018;10(2):6-14.
- 9. Banks PA, Bollen TL, Dervenis C, Gooszen HG, et al. Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11.
- 10. A R Subhashree, Parameaswari PJ, Shanthi B, et al.The refe-rence intervals for the haematological parameters in healthy adult population of chennai, southern India. J Clin Diagn Res. 2012;6(10):1675-80.
- 11. Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepa-tol 2011; 9:1098.
- 12. Lei JJ, Zhou L, Liu Q, Xiong C,et al. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol. 2017;23(13):2404-2413
- 13. Murat Özgür K, Canbert Ç, Cemil Y,et al. Correlation between Ranson score and red cell distribution width in acute pancre-atitis. Ulus Travma Acil Cerrahi Derg 2017; 23(2): 112-116
- 14. Önmez, A. , Bilir, E. , Torun, S. "Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki". Konuralp Medical Journal 2019;11: 24-29.
- 15. Karacabey S. The value of red cell dsitribution width (rdw) predicting mortality in acute pancreatitis. Bozok tıp dergisi . 2018;8(1):109-113.
- 16. Lv YC, Yao YH, Zhang J, Wang YJ, Lei JJ. Red cell distribution width: A predictor of the severity of hypertriglyceridemia-induced acute pancreatitis. World J Exp Med. 202313(5):115-122. doi: 10.5493/wjem.v13.i5.115.
- 17. Heidari B, Alireza H, Seyed , Amir S, Mojtaba B, Afsane T,et al. Hypertriglyceridemia Is Associated With White Blood Cell Count and Red Cell Distribution Width: A Gender Stratified Analysis in a Population-Based Study. Acta medica Iranica. 2018;56:645.
- 18. Papadopoulos VP, Filippou DK, Mimidis KP. Mean platelet volume in acute pancreatitis: a systematic review and meta-analysis. Ann Gastroenterol. 2020;33(4):398-404.
Öz
Background: Background: In acute pancreatitis (AP), determining the severity of the disease starting from hospitalization is important for planning the treatment. Data obtained in previous studies that examining the clinical importance of RDW (Erythrocyte Distribution Volume) and MPV (Mean Plate-let Volume) levels in patients with AP are contradictory. Our aim in this study is to determine whether RDW and MPV levels can predict the severity of pancreatitis and related mortality.
Materials and Methods: The data of 262 patients hospitalized due to AP between 2019 and 2022 were retrospectively examined. Patients were divided into groups according to Atlanta crite-ria.Then, the relationship between RDW and MPV values and the severity and prognosis of pancrea-titis was examined statistically.
Results: While 83.9% (n=220) of the patients had mild pancreatitis, 16.1% (n=42) had severe pan-creatitis. While the mean RDW index was 42.5±6.9 fL in patients with mild AP, it was 42.0±6.6 fL in severe AP patients and there was no significant difference between the two groups (p=0.625). In addition, there was no significant difference between the two groups in terms of mean MPV level (9.7±1.0 fL vs 9.8±1.3 Fl, p=0.687). ROC analysis showed that there was no significant and critical MPV and RDW threshold value to detect the severity of pancreatitis (AUC values: 0.499 and 0.453, respectively).
Conclusions: In our study, we found that there was no significant difference in terms of RDW and MPV in patients with mild and severe pancreatitis according to the Atlanta criteria. Therefore, we can say that MPV and RDW levels are not sufficient and strong parameters to predict the severity and prognosis of pancreatitis.
Key Words: Acute Pancreatitis, Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV)
Kaynakça
- 1. Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute panc-reatitis. Lancet. 2020;396(10252):726-734.
- 2. Ugur Fahri Y, Esat Taylan U. Akut Pankreatitte Tiyol Disülfit Homeostazı Hastalık Lehine Bozulmaktadır. Dicle Tıp Dergisi / Dicle Med J 2023;50(3):391-397,
- 3. Venkatesh NR, Vijayakumar C, Balasubramaniyan G, et al. Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study. Cureus. 2020;12(2):e6943.
- 4. Constantino B. Red cell distribution width, revisi-ted. Laboratory Medicine. 2013;44(2):e2-e9.
- 5. Sargent S. Pathophysiology, diagnosis and management of acute pancreatitis. Br J Nurs. 2006;15(18):999-1005.
- 6. Kara H, Doğru A, Değirmenci S, et al. Diagnostic value of neutrophil-to-lymphocyte ratio in emergency department pa-tients diagnosed with acute pancreatitis. Cukurova Medical Journal. 2016;41(1):55-60.
- 7. Feng GH, Li HP, Li QL. et al. Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol. 2017;2(3):172-175.
- 8. Lippi G, Turcato G, Cervellin G et al. Red blood cell distribu-tion width in heart failure: A narrative review. World J Car-diol. 2018;10(2):6-14.
- 9. Banks PA, Bollen TL, Dervenis C, Gooszen HG, et al. Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11.
- 10. A R Subhashree, Parameaswari PJ, Shanthi B, et al.The refe-rence intervals for the haematological parameters in healthy adult population of chennai, southern India. J Clin Diagn Res. 2012;6(10):1675-80.
- 11. Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepa-tol 2011; 9:1098.
- 12. Lei JJ, Zhou L, Liu Q, Xiong C,et al. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol. 2017;23(13):2404-2413
- 13. Murat Özgür K, Canbert Ç, Cemil Y,et al. Correlation between Ranson score and red cell distribution width in acute pancre-atitis. Ulus Travma Acil Cerrahi Derg 2017; 23(2): 112-116
- 14. Önmez, A. , Bilir, E. , Torun, S. "Akut Pankreatit Şiddeti ile Trombosit Lenfosit Oranı, Nötrofil Lenfosit Oranı, Eritrosit Dağılım Genişliği ve Ortalama Platelet Volümü Arasındaki İlişki". Konuralp Medical Journal 2019;11: 24-29.
- 15. Karacabey S. The value of red cell dsitribution width (rdw) predicting mortality in acute pancreatitis. Bozok tıp dergisi . 2018;8(1):109-113.
- 16. Lv YC, Yao YH, Zhang J, Wang YJ, Lei JJ. Red cell distribution width: A predictor of the severity of hypertriglyceridemia-induced acute pancreatitis. World J Exp Med. 202313(5):115-122. doi: 10.5493/wjem.v13.i5.115.
- 17. Heidari B, Alireza H, Seyed , Amir S, Mojtaba B, Afsane T,et al. Hypertriglyceridemia Is Associated With White Blood Cell Count and Red Cell Distribution Width: A Gender Stratified Analysis in a Population-Based Study. Acta medica Iranica. 2018;56:645.
- 18. Papadopoulos VP, Filippou DK, Mimidis KP. Mean platelet volume in acute pancreatitis: a systematic review and meta-analysis. Ann Gastroenterol. 2020;33(4):398-404.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Gastroenteroloji ve Hepatoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 15 Mart 2024 |
| Yayımlanma Tarihi | 29 Nisan 2024 |
| Gönderilme Tarihi | 12 Kasım 2023 |
| Kabul Tarihi | 21 Şubat 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 21 Sayı: 1 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty