Enhanced red blood cell distribution width to platelet ratio is a predictor of mortality in patients with sepsis: a propensity score matching analysis based on the MIMIC-IV database

Abstract

ObjectiveTo explore the association between dynamic changes in red blood cell distribution width to platelet count ratio (RPR) during hospitalisation and short-term mortality in patients with sepsis.DesignA retrospective cohort study using propensity score matching.SettingIntensive care units (ICUs) of Beth Israel Deaconess Medical Center.ParticipantsA total of 8731 adult patients with sepsis were included in the study. The patients were identified from the ICU of the Medical Information Mart for Intensive Care database. The observed group included patients who experienced an increase in RPR of more than 30% during the first week of ICU admission, whereas the control group included the rest.Main outcome and measureUsing propensity score matching, a matched control group was created. The primary outcome was 28-day mortality, and the length of hospital stay and in-hospital mortality were the secondary outcomes.ResultsThe difference was evident in 28-day mortality between the two groups (85.8% vs 74.5%, p<0.001, Kaplan-Meier analysis, and HR=1.896, 95% CI=1.659 to 2.168, p<0.001, Cox regression). In the secondary outcomes, there was a significant difference in in-hospital mortality (p<0.001). In addition, the study discovered that the observed groups had a significantly longer hospital stay (p<0.001). Meanwhile, the results of subgroup analyses were consistent with those of the primary analyses.ConclusionsIn patients with sepsis, a significantly increased RPR is positively associated with the short-term death rate. Continuous RPR monitoring could be a valuable measure for predicting short-term mortality in patients with sepsis.

Associations between static and dynamic changes of platelet counts and in-hospital mortality in critical patients with acute heart failure

“…The association of decreased platelet count with poor prognosis has been well supported in studies among different populations, especially in ICU patients 15 – 18 . Nihat Polat et al revealed that in patients with acute decompensated HF, baseline platelet counts were significantly higher in alive patients than in deceased patients, and lower platelet counts predicted an increased risk of death at one year 19 .…”

“…( 1234567890 www.nature.com/scientificreports/ sufficient adjustment for confounders, we found that the early decline in platelet counts was an independent predictor of in-hospital death in critical patients with AHF. The association of decreased platelet count with poor prognosis has been well supported in studies among different populations, especially in ICU patients [15][16][17][18] . Nihat Polat et al revealed that in patients with acute decompensated HF, baseline platelet counts were significantly higher in alive patients than in deceased patients, and lower platelet counts predicted an increased risk of death at one year 19 .…”

Association between haemoglobin-to-red blood cell distribution width ratio at admission and all-cause mortality in adult patients with sepsis in an intensive care unit: a secondary analysis of the MIMIC-IV database

“…Extensive research has identified several indices predictive of sepsis outcomes, including the neutrophil-to-lymphocyte ratio, albumin levels, platelet count and the ratio of red blood cell distribution width (RDW) to platelet count. [5][6][7][8] RDW has emerged as a significant and reliable marker for acute and chronic systemic inflammation. 9 It measures…”