The Ratio of Red Blood Cell Distribution Width to Serum Calcium Level in Predicting the Severity of Acute Pancreatitis

Background & Objective: The present study was designed to investigate the ratio of red blood cell distribution width (RDW) to serum calcium level as a predictor of acute pancreatitis severity. Materials & Methods:In this cross-sectional study, 336 acute pancreatitis patients referred to the emergency rooms of Valiasr and Mousavi hospitals were investigated during the period from 2022 to 2023.Demographic, clinical and laboratory data were obtained from patient records.The data were analyzed using STATA16, and the area under the ROC curve was applied to determine the best cutoff point for the ratio of RDW to serum calcium level.Results: 188 patients had mild pancreatitis and 148 had moderate/severe pancreatitis.The mean age of patients with mild and moderate/severe acute pancreatitis was 60.22 (17.84) and 58.68 (18.53)years, respectively.The frequency of women in mild and moderate/severe pancreatitis was 53.2% and 52%, respectively.The multiple logistic regression model showed that for every one unit increase in the mean RDW to calcium ratio, the odds of developing moderate/severe pancreatitis increased 4.30-fold (OR= 4.30; P<0.001).The best cutoff for the ratio of RDW to serum calcium in predicting moderate/severe acute pancreatitis was 1.69.The sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve for this cutoff were 83.45%, 85.47%, 85.17%, 83.77%, and 0.8698, respectively. Conclusion:The ratio of RDW to serum calcium can be a rapid, accessible, inexpensive, sensitive, and reliable indicator for predicting the severity of acute pancreatitis.