Abstract：Objective To study the value of red blood cell distribution width (RDW)-to-platelet count (PLT) ratio (RPR) on the first day of admission into the pediatric intensive care unit (PICU) in predicting the prognosis of children with sepsis. Methods A retrospective analysis was performed for the clinical data of 186 children with sepsis who were hospitalized in the PICU. According to their prognosis, they were divided into a survival group with 151 children and a death group with 35 children. Clinical data were compared between the two groups. The Cox proportional-hazards regression model analysis was used to investigate the factors influencing the prognosis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of RPR in predicting death. The children were divided into a high RPR group and a low RPR group according to the optimal cut-off value, and the Kaplan-Meier method was used to compare the 28-day survival rate between the two groups. Results Compared with the survival group, the death group had significantly higher RDW, procalcitonin (PCT) and RPR (P < 0.05) and significantly lower PLT and albumin (ALB) (P < 0.05). The Cox regression model analysis showed that low ALB, high PCT and high RPR were independent risk factors for the prognosis of children with sepsis (P < 0.05). The ROC curve analysis showed that RPR had a certain value in predicting the prognosis of children with sepsis (P < 0.05), with an area under the ROC curve of 0.937, an optimal cut-off value of 0.062, a sensitivity of 94.29%, and a specificity of 77.48%. The Kaplan-Meier survival analysis showed that the high RPR group had a significantly lower 28-day survival rate than the low RPR group (P < 0.05). Conclusions RPR on the first day of admission into the PICU is closely associated with the prognosis of children with sepsis and has an important value in predicting the prognosis of children with sepsis.
WANG Li,CAI Qiang. Value of red blood cell distribution width-to-platelet count ratio in predicting the prognosis of children with sepsis[J]. CJCP, 2019, 21(11): 1079-1083.
Jo YH, Kim K, Lee JH, et al. Red cell distribution width is a prognostic factor in severe sepsis and septic shock[J]. Am J Emerg Med, 2013, 31(3):545-548.
[2]
Sertoglu E, Tapan S, Uyanik M. Important details about the red cell distribution width[J]. J Atheroscler Thromb, 2015, 22(2):219-220.
[3]
Magri CJ, Fava S. Red blood cell distribution width and diabetes-associated complications[J]. Diabetes Metab Syndr, 2014, 8(1):13-17.
[4]
Cetinkaya E, Senol K, Saylam B, et al. Red cell distribution width to platelet ratio:new and promising prognostic marker in acute pancreatitis[J]. World J Gastroenterol, 2014, 20(39):14450-14454.
[5]
Lee JH, Chung HJ, Kim K, et al. Red cell distribution width as a prognostic marker in patients with community-acquired pneumonia[J]. Am J Emerg Med, 2013, 31(1):72-79.
Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock, 2012[J]. Intensive Care Med, 2013, 39(2):165-228.
Ephrem G. Red blood cell distribution width should indeed be assessed with other inflammatory markers in daily clinical practice[J]. Cardiology, 2013, 124(1):61.
[14]
Miyamoto K, Inai K, Takeuchi D, et al. Relationships among red cell distribution width, anemia, and interleukin-6 in adult congenital heart disease[J]. Circ J, 2015, 79(5):1100-1106.
[15]
Salgado MT, Cao Z, Nagababu E, et al. Red blood cell membrane-facilitated release of nitrite-derived nitric oxide bioactivity[J]. Biochemistry, 2015, 54(44):6712-6723.
[16]
de Stoppelaar SF, van't Veer C, van der Poll T. The role of platelets in sepsis[J]. Thromb Haemost, 2014, 112(4):666-677.
[17]
Hudzik B, Szkodzinski J, Gorol J, et al. Platelet-to-lymphocyte ratio is a marker of poor prognosis in patients with diabetes mellitus and ST-elevation myocardial infarction[J]. Biomark in Med, 2015, 9(3):199-207.
