Abstract:

Objective To investigate the changes of neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， and red cell distribution width （RDW） in the peripheral blood of the patients with post-traumatic sepsis， and to clarify their predictive values for prognosis. Methods The clinical data of 651 patients admitted to the intensive care unit （ICU） due to trauma from June 2021 to June 2025 were retrospectively analyzed. The patients were divided into sepsis group and non-sepsis group according to whether sepsis occurred during treatment. The patients in sepsis group were further divided into death group and survival group regarding their survival within 28 days after confirmed diagnosis of sepsis. The clinical indicators in the patients in various groups were compared. Multivariate Logistic regression model was used to analyze the risk factors for death in the sepsis patients. Receiver operating characteristic （ROC） curve method was used to evaluate the predictive values of the indexes for the prognosis of sepsis patients. Results A total of 436 cases （66.97%） were included in non-sepsis group， and 215 cases （33.03%） were included in sepsis group. Compared with non-sepsis group， the NLR， PLR and RDW of the patients in sepsis group were significantly increased（P<0.05）. In the patients with sepsis， 128 cases （59.53%） were included in survival group， and 87 cases （40.47%） were included in death group. Compared with survival group， the Sequential Organ Failure Assessment （SOFA） score， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score， white blood cell count （WBC）， lactate （LAC） level， NLR， PLR and RDW were significantly increased in the patients in death group （P<0.001）. Elevated SOFA score， elevated APACHE Ⅱ score， elevated LAC， elevated NLR， elevated PLR， and elevated RDW were the independent risk factors for death in sepsis patients （P<0.05）. The areas under the curve （AUCs） of LAC， NLR， PLR， RDW， combined detection of NLR， PLR and RDW， and combined detection of LAC， NLR， PLR and RDW were 0.750， 0.699， 0.740， 0.730， 0.835， and 0.875， respectively. Conclusion Elevated NLR， PLR and RDW are associated with the occurrence of post-traumatic sepsis and poor prognosis of patients. The above indices are independent risk factors for death in sepsis patients. Combined detection of NLR， PLR and RDW shows certain predictive value for the prognosis of sepsis patients.

Key words: Sepsis, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Red blood cell distribution width, Prognosis