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A Fast and Reliable Method to Interpret Short-Term Mortality in Perforated Peptic Ulcer: Red Cell Distribution Width
Okan Murat Akturk1, Mikail Çakır1, Yaşar Murat Vardar1
1Department of Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.
Insights
Red cell distribution width (RDW) may help predict mortality in patients with peptic ulcer perforation. Higher RDW levels were significantly associated with in-hospital death in this patient group.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Hematology
Background:
- Peptic ulcer disease affects approximately 5% of the global population.
- Peptic ulcer perforation is a severe complication with significant mortality.
- Identifying prognostic markers is crucial for managing peptic ulcer perforation.
Purpose of the Study:
- To evaluate red cell distribution width (RDW) as a prognostic indicator for mortality in patients with peptic ulcer perforation.
- To determine the association between RDW levels and in-hospital mortality.
Main Methods:
- Retrospective cohort study analyzing patient records, operation notes, and laboratory parameters.
- Included 172 patients operated for peptic ulcer perforation.
- Assessed the correlation between RDW and in-hospital mortality.
Main Results:
- In-hospital mortality rate was 8.7% (15/172 patients).
- Median RDW was significantly higher in patients who died (15.00) compared to survivors (13.2) (p ≤ 0.001).
- RDW demonstrated a significant area under the curve (0.812) in predicting mortality, with a cutoff of 14.25% showing 80% sensitivity and 82.17% specificity.
Conclusions:
- Elevated red cell distribution width (RDW) is a potential predictor of mortality in peptic ulcer perforation.
- RDW can aid in interpreting prognosis for patients with this condition.
Introduction:
Peptic ulcer is an important health problem worldwide with a prevalence of around 5%. Peptic ulcer perforation is a potentially mortal complication of peptic ulcer disease. We aimed to investigate the potential use of red cell distribution width as a prognostic marker in peptic ulcer perforation.
Methods:
The files, operation notes, biochemical and hematological parameters, and prognosis of patients who were operated for a peptic ulcer perforation were reviewed in a retrospective cohort study. The relation of red cell distribution width (RDW) to main outcome in-hospital mortality was assessed.
Results:
The mean age of the 172 patients was 40 ± 17.89. There were 158 (92%) males and 14 (8%) females. The in-hospital mortality was 8.7% (15/172). The median RDW in the group with mortality was 15.00 (interquartile range (IQR): 14.30-17.20) compared with the median RDW in the group with no mortality as 13.2 (IQR: 12.80-14.00, p ≤ 0.001). Receiver operator characteristic curves were plotted for RDW to identify nonsurvivors and yielded a significant area under the curve as 0.812 (95% confidence interval: 0.682-0.942). The sensitivity and specificity of RDW at a cutoff value of 14.25% were calculated with an accuracy of 81.98 (95% confidence interval: 75.40-87.41) as 80.00 (51.91-95.67) and 82.17 (75.27-87.81), respectively.
Conclusion:
Increased RDW may be of use to interpret mortality in patients with peptic ulcer perforation.
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