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. 2022 Sep 27:2022:4915887.
doi: 10.1155/2022/4915887. eCollection 2022.

Association of Red Cell Distribution Width-to-Platelet Ratio and Mortality in Patients with Sepsis

Jie Liu  1   2 , Xueying Huang  1   2 , Suru Yue  1 , Jia Wang  1 , Enlin Ye  1 , Jiasheng Huang  1 , Yumei Zhao  1 , Dongdong Niu  1 , Xuefei Hou  1 , Jiayuan Wu  1   2
Affiliations

Association of Red Cell Distribution Width-to-Platelet Ratio and Mortality in Patients with Sepsis

Jie Liu et al. Mediators Inflamm. .

Abstract

Background: As a novel inflammatory index, the ratio of red cell distribution width (RDW) to platelet count (RPR) may have prognostic value in some critical illnesses. However, studies on the prognostic influence of RPR in patients with sepsis are few. This study is aimed at investigating the association between RPR levels and 28-day mortality in patients with sepsis.

Methods: Data of patients with sepsis were obtained from the Medical Information Mart for Intensive Care III database. The best cut-off value was calculated by establishing the receiver operating characteristic curve (ROC), and the predictive ability of different indicators was compared through the area under the curve (AUC). The association between RPR levels and 28-day mortality was assessed using the Cox proportional hazards model. Restrictive cubic spline analysis was applied to the multivariable Cox model to investigate the nonlinear relationship between RPR and 28-day mortality.

Results: A total of 3367 patients with sepsis were included in the study. A nonlinear relationship was observed between RPR and 28-day mortality, showing a trend of a first rapid increase and a gradual increase. For the prediction of mortality, the best cut-off value for RPR was 0.109, with an AUC of 0.728 (95% confidence interval [CI]: 0.709-0.747). The predictive capability of RPR was superior to those of RDW, platelet, SOFA score, and SAPS II score. After adjusting for various confounding factors, high RPR was significantly associated with increased mortality with adjusted hazard ratios of 1.210 (95% CI: 1.045-1.400) for categorical variables and 2.826 (95% CI: 2.025-3.944) for continuous variables.

Conclusion: Elevated RPR level is significantly correlated with a high risk of 28-day mortality in patients with sepsis and can be a new predictor of patient prognosis.

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Conflict of interest statement

The authors declare that there is no conflict of interests.

Figures

Figure 1
Figure 1
The relationship between RPR levels and 28-d mortality in patients with sepsis was plotted using multivariable adjusted restricted cubic splines. There was a nonlinear relationship between RPR and 28-d mortality, showing a trend of rapid first and then gradually increasing, that is, the higher the RPR level, the higher the mortality risk. The range area represents a 95% confidence interval. HR: hazard ratio; CI: confidence interval; RPR: red cell distribution width to platelet ratio.
Figure 2
Figure 2
Receiver operating characteristics curves of RPR, RDW, platelet, SOFA, and SAPS II score for predicting 28-d mortality in patients with sepsis. The predictive ability of PRR for 28-d mortality outperformed other indices, including RDW, platelet, SOFA score, and SAPS II score by comparing the area under the curve. RPR: red cell distribution width to platelet ratio; RDW: red cell distribution width; SOFA: sequential organ failure assessment; SAPS II: simplified acute physiology score II.
Figure 3
Figure 3
Kaplan-Meier analysis of 28-d mortality by the RPR levels in patients with sepsis. The 28-d mortality rate in the high RPR group was significantly higher than that in the low RPR group (log-rank test, P < 0.001). RPR: red cell distribution width to platelet ratio.
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