Early Predictive Value of Peripheral Inflammatory Index Combined with High-Sensitivity Troponin T for Sepsis-Induced...

Sepsis-induced cardiomyopathy (SICM) is a common and serious complication of sepsis, and early identification remains challenging. Inflammatory and immune markers may provide complementary information to myocardial injury biomarkers.

A total of 319 adult patients with a first diagnosis of sepsis between June 2022 and January 2025 were enrolled. Complete blood counts and high-sensitivity cardiac troponin T (hs-cTnT) were collected within 0-6 hours after diagnosis. SICM was determined based on clinical and imaging data. Peripheral blood inflammatory indices (PBIIs), including NLR, SII, SIRI, PLR, and PIV, were calculated from blood counts. Variable robustness was assessed using LASSO logistic regression combined with bootstrap resampling. Univariate and multivariate logistic regression analyses were then performed to construct predictive models, and model performance was evaluated using ROC curves, calibration curves, and decision curve analysis.

Among 319 patients with sepsis, 115 (36.1%) developed SICM. Compared with the non-SICM group, patients with SICM had significantly higher hs-cTnT levels, indicating more severe myocardial injury. Peripheral inflammatory indices were also higher overall, with the largest between-group differences observed for SII and NLR. SIRI and PLR were also elevated, whereas PIV showed a smaller difference (all P<0.05). The baseline model including hs-cTnT achieved an AUC of 0.825; adding SII or NLR further improved discrimination, with AUCs of 0.856 and 0.860, respectively. Calibration and decision curve analyses showed consistent model performance.

SII and NLR, as readily available peripheral inflammatory markers, were associated with improved early prediction of SICM when combined with hs-cTnT. This combined strategy may help refine early risk stratification in patients with sepsis.