Comparative predictive value of nine inflammation-derived haematological indices for 28-day mortality in patients with sepsis: a multicentre retrospective cohort study - Report - MDSpire
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Comparative predictive value of nine inflammation-derived haematological indices for 28-day mortality in patients with sepsis: a multicentre retrospective cohort study
Clinical Report: Evaluating the Prognostic Utility of Nine Hematological Indices
Overview
This study investigates the prognostic value of nine inflammation-derived hematological indices for predicting 28-day mortality in sepsis patients. While these indices were associated with mortality in the development cohort, their predictive ability was not validated in the external cohort, as no significant associations were found.
Background
Sepsis is a significant cause of mortality globally, with approximately 50 million cases annually. Early risk stratification is crucial for improving outcomes, yet existing scoring systems can be complex and less applicable in real-time settings. This study aims to evaluate simpler, readily available hematological indices for their prognostic utility in sepsis, based on their associations with mortality.
Data Highlights
Index
Association with Mortality
Neutrophil-to-lymphocyte ratio
Significantly associated
Platelet-to-lymphocyte ratio
Significantly associated
Monocyte-to-lymphocyte ratio
Significantly associated
Neutrophil-to-monocyte ratio
Significantly associated
Neutrophil-to-platelet ratio
Significantly associated
Monocyte-to-platelet ratio
Significantly associated
Systemic immune-inflammation index
Significantly associated
Systemic inflammation response index
Significantly associated
Aggregate index of systemic inflammation
Significantly associated
Key Findings
All nine indices were significantly associated with 28-day mortality in the development cohort.
The neutrophil-to-lymphocyte ratio had the highest area under the curve for mortality prediction.
Monocyte-to-lymphocyte ratio, neutrophil-to-platelet ratio, and systemic inflammation response index had larger effect estimates in the fully adjusted model.
External validation showed no significant associations between the indices and 28-day mortality.
Non-linear associations were observed between all indices and mortality risk.
Clinical Implications
The findings suggest that while inflammation-derived hematological indices can indicate mortality risk in sepsis, their standalone predictive ability is limited. Clinicians should consider these indices as supplementary tools rather than primary predictors of mortality.
Conclusion
Inflammation-derived hematological indices show associations with 28-day mortality in sepsis but lack consistent validation across cohorts.
