Can red cell distribution width be used as a predictor of acute cholecystitis?

Clinical importance of preoperative red-cell volume distribution width as a prognostic marker in patients undergoing radical surgery for pancreatic cancer

Background and purpose

A new noninvasive biomarker is being sought to predict the prognosis of patients with pancreatic cancer. Red-cell volume distribution width (RDW), a descriptive parameter for erythrocyte variation, has been shown to have prognostic value for some tumor types. Our purpose was to assess the RDW value to predict the prognosis of patients with pancreatic cancer.

Methods

The subjects of this retrospective study were 792 patients who underwent radical surgery for pancreatic cancer, divided into high-RDW and low-RDW groups based on receiver operating characteristic (ROC) curve analysis (15.6%). The controlling nutritional status (CONUT) score was used to assess preoperative nutritional status. Statistical analysis was conducted to investigate the differences between the high and low RDW groups, and to explore the possibility of the RDW being used as prognostic predictor for patients with pancreatic cancer.

Results

The immune-nutritional status was worse in the high-RDW group than in the low-RDW group. The high-RDW group patients also had a poorer prognosis. Risk factor analysis showed that the RDW could be an independent risk factor for pancreatic cancer.

Conclusions

The RDW is associated with immune-nutritional status in pancreatic cancer patients and can be used as an independent prognostic factor for their postoperative survival.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00595-021-02374-7.

Validity of the Glasgow prognostic score and modified systemic inflamma-tion score in predicting complicated cholecystitis

BACKGROUND

Complicated cholecystitis (CC) is the severe form of acute cholecystitis (AC). Clinical, radiological, inflammatory, or biochemical parameters are used to predict presence of CC. We aimed to evaluate the Glasgow prognostic (GPS) and modified systemic inflammation scores (mSIS) that are used to predict presence of CC.

METHODS

We retrospectively analyzed data from patients who underwent AC surgery from January 2014 to August 2019. Collected information included age, gender, length of stay (LOS), pathology [as CC or uncomplicated (UCC)], albumin, C-reactive protein (CRP), white blood cells (WBC), and neutrophils (NEU) results. The lymphocyte-to-monocyte ratio (LMR) was calculated. The GPS was calculated using CRP and albumin levels, and mSIS was calculated using LMR and albumin levels, and it was scored from 0 to 2.

RESULTS

Among the 593 hospitalized patients, 217 patients underwent AC surgery and were included in the study. Among them, 40.1 % of the patients had CC, 53.4 % were male, and the mean age was 51.76 ± 13.8 years. LOS was significantly longer for CC compared to UCC (p =0.018). Four patients died from CC (1.8 %). The mean CRP, WBC, and NEU levels were not different CC compared to UCC (p =0.821, p =0.84, and p =0.196, respectively). The cut-off values for CC were 103.54 mg/L, 15.18 ×10⁶/μL, and 11.79 ×10³/μL, respectively. GPS and mSIS were significantly higher in CC compared to UCC (p =0.008, p =0.022, respectively).

CONCLUSION

CRP, WBC, and NEU could be used to predict presence of CC. The combination of CRP or LMR with albumin could be a positive but weak predictor of CC, and it is quick, easy to use, and reliable. HIPPOKRATIA 2020, 24(1): 15-20.