Red blood cell distribution width and platelet distribution width as a predictive marker in the diagnosis of malignant and benign causes of acute gastrointestinal bleeding.

The main aim of this study is to investigate complete blood count parameters in order to distinguish between benign and malignant causes of bleeding in patients who presented to the emergency department with gastrointestinal bleeding. In our study, we assessed 455 patients who were admitted to the emergency department between January 2022 and December 2023 with upper and lower gastrointestinal bleeding. Patient's data were analyzed retrospectively. The diagnosis of malignancy was established following pathological investigation. The study investigated the relationship between benign and malignant causes and different components of the complete blood count, including white blood cells, neutrophils, lymphocytes, monocytes, red cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume, platelets, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, thrombocyte-lymphocyte ratio, RDW-platelet ratio, and mean platelet volume-platelet ratio. t test and Mann Whitney U test used for parametric and nonparametric scale values. cutoff points, sensitivity and specificity, and area under curve detected with receiver operating characteristic (ROC) curve. Of the 455 patients who applied to the emergency department, 382 (84%) had gastrointestinal bleeding due to benign causes, and 73 (16%) had malignant causes. RDW (P = .008) value was found to be significantly higher in bleeding due to malignant causes. The PDW (P = .017) value was significantly higher in bleeding associated with benign causes. No relationship was found between the other parameters. The ROC curve study revealed that the RDW had the highest diagnostic accuracy for predicting malignancy at a threshold of 14.1, and the area under the curve was 0.654 (95% CI: 0.578-0.729). The ROC curve analysis demonstrated that PDW exhibited the maximum diagnostic accuracy for predicting benign causes at a threshold of 13.8, with an area under the curve of 0.590 (95% CI: 0.502-0.678), showing moderate accuracy. The sensitivity and specificity of the RDW was 86% and 39%, respectively. The sensitivity and specificity of the PDW was 63.95% and 58%, respectively. Our study has shown that the values of RDW and PDW can be valuable in predicting malignant and benign etiology in patients admitted to the emergency department with gastrointestinal bleeding.