The efficacy study of the ratio of red blood cell distribution width to platelet count in the early diagnosis of sepsis induced coagulation disease

DOI: 10.12201/bmr.202509.00026

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  Abstract: Objective: To evaluate the value of red blood cell distribution width/platelet count ratio (RPR) in early warning of septic coagulation disease (SIC). Method: Based on the US Intensive Care Medicine Information Database - IV 3.1 (MIMIC-IV 3.1), 4347 patients with sepsis who were admitted for the first time and had their first stay in the intensive care unit (ICU) and were aged 18 years or older were included.According to the International Society on Thrombosis and Hemostasis (ISTH) recommended SIC score of ≥ 4, patients were divided into SIC group (n=2309) and non SIC group (n=2038). Collect basic information, comorbidities, use of mechanical ventilation and vasoactive drugs, and Sequential Organ Failure Score (SOFA score); Initial laboratory indicators upon admission to the ICU: blood routine, venous blood biochemistry, blood gas analysis, coagulation spectrum; Clinical prognosis: ICU 28 day mortality rate. Use multiple logistic regression and receiver operator characteristic curve (ROC curve) to analyze the diagnostic efficacy of RPR. Result: Compared with the non-SIC group,the SIC group was older and had higher rates of heart failure/myocardial infarction, chronic kidney disease, and vasoactive drug use. SOFA score, red blood cell distribution width RPR、 Liver and kidney function, lactate, prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) all increased; The proportion of hypertension, hemoglobin, platelets, albumin, biochemical calcium, Pondus Hydrogeni (pH), and fibrinogen (FIB) decreased (all P<0.05). The 28 day ICU mortality rate was significantly higher than that of the non SIC group. Multivariate logistic regression analysis revealed that RPR is an independent risk factor for SIC, with an AUC value of 0.808 and an optimal cutoff value of 0.095. The AUC value for INR is 0.915 and the optimal cutoff value is 1.41; The AUC value of RPR combined with INR is 0.988. Conclusion: The ICU 28 day mortality rate in the SIC group is higher than that in the non SIC group. RPR is an independent risk factor for the occurrence of SIC, and its combination with INR can significantly improve early diagnostic accuracy, which deserves clinical attention.

  Key words: ratio of red blood cell distribution width to platelet count; Sepsis; Sepsis-induced coagulopathy；Early warning

  Submit time: 10 September 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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