Prognostic Accuracy of Red Blood Cell Distribution Width in Predicting Mortality Among Acute Pancreatitis Patients: A systematic review and hierarchical bivariate meta-analysis.

Acute pancreatitis (AP), often requiring hospitalisation, is mild in most cases but severe in approximately 20% of cases. Early severity and mortality risk identification are crucial. This systematic review and meta-analysis evaluated the prognostic utility of red blood cell distribution width (RDW) for predicting mortality in AP. A comprehensive literature search from 1990 to 2023 was conducted across MEDLINE, SCOPUS and ScienceDirect databases along with Google Scholar. Methodological quality of included studies was assessed using the Quality in Prognostic Studies tool. Prognostic accuracy measures were pooled using a bivariate random-effects meta-analysis model, and hierarchical summary receiver operating characteristic (ROC) curve was constructed. Of the 1,207 studies identified, 20 were used for quantitative synthesis. The pooled sensitivity and specificity for mortality prediction were 87% and 81%, with an area under the summary ROC curve of 0.90. These findings highlight RDW's potential as a promising biomarker for mortality prediction in AP.