Diagnostic values of red cell distribution width, platelet distribution width and neutrophil-lymphocyte count ratio for sepsis

Abstract

The aim of this study was to evaluate the diagnostic efficiency of red blood cell distribution width (RDW), platelet distribution width (PDW), the neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and C-reactive protein (CRP) for the prediction of sepsis. A total of 120 consecutive patients who underwent blood culture testing were included. The PCT and CRP levels, and RDW, PDW and NLCR percentages were determined and compared between patients with positive blood cultures and those without. The PCT, CRP, RDW, PDW and NLCR values were significantly higher in patients with positive blood culture compared with those without. PCT and NLCR each had a high diagnostic performance for the prediction of sepsis, with an area under the curve (AUC) for sepsis of 0.829 and 0.718, respectively. A combination of RDW, PDW and NLCR also exhibited a good diagnostic performance for sepsis (AUC, 0.704). NLCR is easily obtained by automated hematological analysis. Moreover, NLCR was found to have a high diagnostic efficiency for the prediction of sepsis, with greater sensitivity and accuracy than CRP. In conclusion, PCT exhibited the optimal diagnostic performance among the tested markers. The combination of the three parameters of RDW, PDW and NLCR, demonstrated a high diagnostic performance similar to that of PCT.

Keywords: C-reactive protein; ROC curve; neutrophil-to-lymphocyte ratio; platelet distribution width; procalcitonin; red cell distribution width.

Figure 1.

Receiver operating characteristic (ROC) curves comparing the ability of RDW, PDW, NLCR, PCT, CRP and the combination of three tested parameters (RDW + PDW + NLCR) to distinguish bacteremia from nonbacteremia. RDW, red blood cell distribution width; PDW, platelet distribution width; NLCR, neutrophil-lymphocyte count ratio; PCT, procalcitonin; CRP, C-reactive protein.