Predictive Value of Platelet-Based Indexes for Mortality in Sepsis

Area of Science:

• Critical Care Medicine
• Biomarkers
• Sepsis Pathophysiology

Background:

• Sepsis and septic shock remain leading causes of ICU mortality despite advances in treatment.
• Early prognostic assessment is crucial for guiding clinical decisions in sepsis management.
• Platelet-derived indices offer potential low-cost indicators of inflammation and coagulation in sepsis.

Purpose of the Study:

• To evaluate the predictive performance of various platelet-based ratios for in-hospital mortality in sepsis patients.
• To identify the most effective platelet-derived index for early risk stratification in the ICU.

Main Methods:

• A prospective observational study enrolled 114 adult sepsis/septic shock patients in a tertiary ICU.
• Measured biomarkers included C-reactive protein-to-platelet ratio (CPR), platelet-to-lymphocyte ratio (PLR), platelet-to-white blood cell ratio (PWR), and platelet-to-creatinine ratio (PCR).
• Logistic regression and ROC analyses assessed predictive accuracy for mortality.

Main Results:

• Non-survivors exhibited higher CRP and CPR values and lower platelet/lymphocyte counts compared to survivors.
• CPR demonstrated the highest accuracy in differentiating survivors from non-survivors (AUC 0.757).
• CPR independently predicted in-hospital mortality (OR 1.98), while PLR and PWR did not.

Conclusions:

• CPR is a robust and clinically applicable predictor of early sepsis mortality, surpassing other platelet indices.
• CPR, derived from routine labs, is a valuable tool for initial risk stratification in ICUs.
• Further multicenter studies are needed to validate CPR's prognostic role and integration into existing scoring systems.