Document Type : Original Article


1 Gastrointestinal and Liver Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

3 Student’s Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran


Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis.
Methods: This was a descriptive analytical study performed on 100 patients with acute pancreatitis in the emergency department of Imam Reza hospital of Tabriz University of Medical Sciences. In this study, the primary level of RDW in patients with acute pancreatitis presenting to the emergency ward was collected and after patients’ admission we followed them. Also, the admission outcome (mortality or discharge) of patients was registered, and finally we evaluated the predictive value of RDW in determining the patient’s outcome in hospital.
Results: In our study, 47 patients were male, and 53 patients were female. Mean RDW in patients was 13.82 ± 1.69. Five patients died during the study. Mean RDW in dead patients and other patients was 16.44 ± 4.22 and 13.68 ± 1.37, respectively (P < 0.001). The cut-off point of 14.55 for RDW with 80% sensitivity and 85% specificity was determined for predicting mortality in patients.
Conclusion: Based on our study results, the initial RDW level is an independent factor for predicting in-hospital mortality in pancreatitis but not for determining the need for surgery or admission to the intensive care unit (ICU).


Main Subjects

1. Fisher WE, Anderson DK, Bell RH, Saluja AK, Brunicardi FC. Pancreas. In: Brunicardi FC, Anderson DK, Billiar TR, eds. Schwartzs Principles of Surgery. 8th ed. New York: McGraw-Hill; 2005. p. 1231-40.
2. Wang X, Cui Z, Zhang J, Li H, Zhang D, Miao B, et al. Early predictive factors of in hospital mortality in patients with
severe acute pancreatitis. Pancreas 2010; 39(1): 114-5. doi:10.1097/MPA.0b013e3181b65dd5.
3. Yoldas O, Koc M, Karakose N, Kilic M, Tez M. Prediction of clinical outcomes using artificial neural networks for patients with acute biliary pancreatitis. Pancreas 2008;36(1): 90-2. doi: 10.1097/MPA.0b013e31812e964b.
4. Senol K, Saylam B, Kocaay F, Tez M. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med 2013; 31(4): 687-9. doi: 10.1016/j.ajem.2012.12.015.
5. Song CS, Park DI, Yoon MY, Seok HS, Park JH, Kim HJ, et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease. Dig Dis Sci 2012; 57(4): 1033-8. doi: 10.1007/s10620-011-1978-2.
6. Zorlu A, Bektasoglu G, Guven FM, Dogan OT, Gucuk E, Ege MR, et al. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol 2012; 109(1): 128-34. doi:10.1016/j.amjcard.2011.08.015.
7. Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, et al. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med 2013; 31(3): 545-8. doi:10.1016/j.ajem.2012.10.017.
8. Wang F, Pan W, Pan S, Ge J, Wang S, Chen M. Red cell distribution width as a novel predictor of mortality in ICU patients. Ann Med 2011; 43(1): 40-6. doi:10.3109/07853890.2010.521766.
9. Naing L. Sample size for sensitivity and specificity studies. Available from:
10. Hemphill RR, Santen SA. Disorders of the Pancreas In: Marx JA, ed. Rosen’s Emergency Medicine. Philadelphia: Elsevier Saunders; 2014. p. 1205-15.
11. Safari S, Rahmani F, Soleimanpour H, Ebrahimi Bakhtavar H, Mehdizadeh Esfanjani R. Can APACHE II score predict
diabetic ketoacidosis in hyperglycemic patients presenting to emergency department? Anesth Pain Med 2014; 4(4): e21365. doi: 10.5812/aapm.21365.
12. Wu BU, Bakker OJ, Papachristou GI, Besselink MG, Repas K, van Santvoort HC, et al. Blood urea nitrogen in the early
assessment of acute pancreatitis: an international validation study. Arch Intern Med 2011; 171(7): 669-76. doi: 10.1001/
13. Anderson JL, Ronnow BS, Horne BD, Carlquist JF, May HT, Bair TL, et al. Usefulness of a complete blood countderived
risk score to predict incident mortality in patients with suspected cardiovascular disease. Am J Cardiol 2007;99(2): 169-74. doi: 10.1016/j.amjcard.2006.08.015.
14. Yao J, Lv G. Association between red cell distribution width and acute pancreatitis: a cross-sectional study. BMJ Open
2014; 4(8): e004721. doi: 10.1136/bmjopen-2013-004721.
15. Kolber W, Sporek M, Dumnicka P, Kusnierz-Cabala B, Kuzniewski M, Gurda-Duda A, et al. Acute pancreatitis and
red cell distribution width (RDW)I at early phase of disease. Przegl Lek 2013; 70(11): 916-9. [In Polish].
16. Carnovale A, Rabitti PG, Manes G, Esposito P, Pacelli L, Uomo G. Mortality in acute pancreatitis: is it an early or a
late event? Jop 2005; 6(5): 438-44.
17. Makhoul BF, Khourieh A, Kaplan M, Bahouth F, Aronson D, Azzam ZS. Relation between changes in red cell distribution
width and clinical outcomes in acute decompensated heart failure. Int J Cardiol 2013; 167(4): 1412-6. doi: 10.1016/j.
18. Hong N, Oh J, Kang SM, Kim SY, Won H, Youn JC, et al. Red blood cell distribution width predicts early mortality in
patients with acute dyspnea. Clin Chim Acta 2012; 413(11-12): 992-7. doi: 10.1016/j.cca.2012.02.024.
19. Braun E, Domany E, Kenig Y, Mazor Y, Makhoul BF, Azzam ZS. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia. Crit Care 2011; 15(4): R194. doi: 10.1186/
20. Horne BD. A changing focus on the red cell distribution width: why does it predict mortality and other adverse
medical outcomes? Cardiology 2012; 122(4): 213-5. doi:10.1159/000341244.
21. Kurt M, Tanboga IH, Buyukkaya E, Karakas MF, Akcay AB, Sen N. Relation of red cell distribution width with CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation. Clin Appl Thromb Hemost 2014; 20(7): 687-92.
doi: 10.1177/1076029613478157
22. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007;50(1): 40-7. doi: 10.1016/j.jacc.2007.02.067.
23. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008; 117(2): 163-8. doi: 10.1161/
24. Spell DW, Jones DV Jr, Harper WF, David Bessman J. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004; 28(1): 37-42. doi:10.1016/j.cdp.2003.10.002.
25. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci 2009; 277(1-2): 103-8. doi: 10.1016/j.jns.2008.10.024.