<p>The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study</p>

Abstract

Background: Sepsis is a life-threatening and inflammatory disease with high morbidity and mortality. Red blood cell distribution width to platelet count ratio (RPR) was known as an inflammatory biomarker and was related to poor outcomes of various diseases. Aim: This study was intended to explore the association between RPR and mortality of sepsis patients. Methods: A retrospective cohort study was undertaken in patients with sepsis, and the data were collected from a public database called Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was 28-day mortality while the secondary outcomes were 90-day mortality and ICU mortality. Multivariable regression analyses, as well as interaction and stratified analyses, were conducted to investigate the relation between RPR and sepsis mortality. Results: In total, we enrolled 7531 patients with 1316 deaths. RPR was independently correlated with 28-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.02-1.06), 90-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.03-1.06) and ICU mortality (per 0.1 increase: OR=1.06; 95% CI 1.02-1.10). Twenty-eight-day survival was worse in the high RPR (≥0.134) group according to the Kaplan-Meier curve analyses (Log rank test, p<0.001). In stratified analyses, Sequential Organ Failure Assessment (SOFA) score and length of ICU stay had interactive effects with the high RPR (≥0.134) group on 28-day mortality. Conclusion: RPR is a novel biomarker that indicates poor prognosis of sepsis patients. Clinicians are required to pay more attention to those patients with high RPR.

Relationship between the red cell distribution width-to-platelet ratio and in-hospital mortality among critically ill patients with acute myocardial infarction: a retrospective analysis of the MIMIC-IV database

“…In addition, RPR also showed good predictive ability for mortality in patients with sepsis, breast cancer, severe burn injury and neonates. 21–23 46 Similarly, our study is consistent with previous results. In this study, we found that RPR was an independent predictor of in-hospital mortalityin critically ill patients with AMI.…”

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

“…Ge et al revealed that the basal RPR is associated with an increased risk of death in individuals with sepsis, 18 consistent with our findings. The study measured RPR only once; however, in our study, an increased amplitude in RPR was used as exposure of interest.…”

“…The severity of the inflammatory response is considered to be reflected by a single RPR at baseline, which can be used to predict the sepsis-related adverse outcomes. 18 According to the two previous studies, RPR has a significant diagnostic and prognostic potential in paediatric and neonatal sepsis. 19 20 Furthermore, baseline RPR has been recommended as a potentially valuable prognostic index for breast cancer, 21 liver fibrosis, 22 severe burn injuries 23 and deep-seated intracerebral bleeding.…”

Elevated Red Cell Distribution Width to Platelet Ratio Is Associated With Poor Prognosis in Patients With Spontaneous, Deep-Seated Intracerebral Hemorrhage

“…In the inflammatory process, in addition to sepsis-related anemic events, inflammatory cytokines may inhibit the maturation of RBCs and thus alter the RDW ( 32 ) whereas platelets are known to be placed on the intersection of an immune response and coagulation in infectious diseases ( 33 ). Thus, a marker as RPR, which takes into account both potential reflections of the inflammatory process, may be more accurate than non-specific markers such as CRP ( 34 , 35 ). Also, in the anticipation of further complications in the course of treatment of ICH (e.g., renal replacement therapy), non-specific markers such as CRP have been reported to be less predictive than those that are considered more specific for inflammatory processes, such as PCT ( 6 ).…”