The Significance Of Red Blood Cell Distribution Width To Albumin Ratio In Evaluating The Severity Of Sepsis

Objective: To investigate the relationship between red cell volume distribution width/albumin ratio(RAR)and the severity and prognosis of patients with sepsis,and to explore the application value of RAR in the evaluation of sepsis.Methods:(1)According to the definition of sepsis 3.0 and meeting the inclusion and exclusion criteria of this experiment,a retrospective study was conducted.A total of 88 patients with sepsis(59 males and 29 females)treated in the Department of Critical Care Medicine of the People’s Hospital of Guangxi Zhuang Autonomous Region from May 2020 to December 2022 were selected as the observation group.The patients were divided into sepsis without shock group(n = 24)and septic shock group(n = 64)according to the severity of the disease(with or without shock),and the patients were divided into survival group(n = 54)and death group(n = 34)according to the 28-day outcome.Another 43 infected non-septic patients(25 males and 18 females)were selected as the control group.(2)The general data of the patients(gender,age,main underlying disease,infection site,28-day outcome,acute physiology and chronic health evaluation score,acute physiology and Chronic Health Evaluation score)were collected.APACHE II),sequential organ failure assessment(SOFA),etc.),And the first blood routine(red blood cell distribution width,white blood cell,platelet,hemoglobin),biochemistry(total bilirubin,creatinine,urea,albumin),blood gas analysis(lactic acid),interleukin-6 and other laboratory indicators within 24 hours after admission to the intensive care unit.The ratio was calculated by dividing the red blood cell distribution width value by the albumin value(%/g/d L).(3)The general data and clinical data of the two groups were compared,and the correlation between red blood cell distribution width to albumin ratio(RAR)and sepsis was explored by statistical methods.Results:(1)The level of RAR in patients with sepsis in the observation group was5.6(4.8,6.47)%/g/d L,which was significantly higher than 3.7(3.3,4)%/g/d L in patients without sepsis in the control group,the difference between the two groups was statistically significant(P <0.05).ROC curve showed that the area under curve(AUC)was 0.908,95%CI: 0.854-0.963(P <0.05),the best predictive value of RAR in the diagnosis of infection complicated with sepsis was greater than 4.75%/g/d L,the sensitivity was 76.1%,and the specificity was90.7%.When the patient’s RAR≥4.75%/g/d L,the patient was more likely to be complicated with sepsis.(2)Multivariate logistic regression analysis showed that the increase of RAR(OR= 2.45,P<0.05)and LAC(OR=1.79,P<0.05)were independent risk factors affecting the severity of sepsis.(3)Multivariate logistic regression analysis showed that gender and primary infection site were independent risk factors for poor prognosis in patients with sepsis(P<0.05).However,age,RAR,Urea,APACHE II score and SOFA score were not independent risk factors for poor prognosis in patients with sepsis(P>0.05).Conclusion: 1.RAR has a certain significance in the diagnosis of sepsis,and can be used as one of the potential indicators for the diagnosis of sepsis.2.RAR has a certain role in evaluating the severity of sepsis.3.RAR has a certain correlation with the prognosis of patients with sepsis,but RAR is not an independent risk factor for the prognosis of patients with sepsis.