Clinical significance of red blood cell volume distribution width/platelet combined with Logistic organ dysfunction score in predicting the prognosis of sepsis complicated with pneumonia

doi:10.3877/cma.j.issn.1674-6902.2026.01.014

Abstract

Abstract:

Objective

To analyze the correlation between the red blood cell volume distribution width/platelet ratio (RDW/PLT) combined with the Logistic organ dysfunction score (LODS) and disease severity in patients with sepsis complicated by pneumonia.

Methods

A total of 153 patients with sepsis complicated by pneumonia admitted to our hospital from January 2018 to December 2024 were enrolled. They were divided into groups according to prognosis during hospitalization: 99 survivors served as the control group, and 54 non-survivors as the observation group. Clinical data were collected, and comparisons were made between the two groups regarding mechanical ventilation, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, LODS score, RDW, and RDW/PLT on day 1, day 3, day 5, and day 7 (D1 RDW/PLT, D3 RDW/PLT, D5 RDW/PLT, D7 RDW/PLT). Binary logistic regression was used to analyze factors influencing prognosis, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of LODS score and RDW/PLT for disease severity in sepsis with pneumonia.

Results

Logistic regression analysis showed that invasive mechanical ventilation (OR=11.095, 95%CI: 1.923~12.816), APACHE Ⅱ score (OR=0.916, 95%CI: 0.840~0.999), high D7 RDW (OR=1.448, 95%CI: 1.149~1.825), high D7 RDW/PLT (OR=8.020, 95%CI: 1.077~59.744), and high LODS score (OR=1.293, 95%CI: 1.091~1.531) were risk factors for death in patients with sepsis complicated by pneumonia (P<0.05). ROC curve analysis showed that the area under the curve (AUC) values for invasive mechanical ventilation, APACHE Ⅱ score, D7 RDW, D7 RDW/PLT, and LODS score were 0.628, 0.606, 0.727, 0.830, and 0.719, respectively. The optimal cutoff value for D7 RDW/PLT was 0.135, with a sensitivity of 79.6% and specificity of 74.7%. The optimal cutoff value for LODS score was 9.5 points, with a sensitivity of 55.6% and specificity of 80.8%. The combined prediction had an AUC of 0.872, with a sensitivity of 83.3% and specificity of 77.8% (P<0.01).

Conclusion

The combination of RDW/PLT and LODS score has clinical significance in predicting disease severity in patients with sepsis complicated by pneumonia.

Key words: Sepsis, Pneumonia, Logistic organ dysfunction score, Red blood cell volume distribution width and platelet ratio

linxin Chen, Lihan Shen, minshan Qiu, ruiyu Lu, yanbo Lai, Ruidong Du, minzhen Lu, Jie Wang. Clinical significance of red blood cell volume distribution width/platelet combined with Logistic organ dysfunction score in predicting the prognosis of sepsis complicated with pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(01): 89-94.

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References 26

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临床资料	观察组(n＝54)	对照组(n＝99)	χ²/t/Z值	P值
性别[n(%)]			0.782	0.376
男	35(64.81)	71(71.72)
女	19(35.19)	28(28.28)
糖尿病[n(%)]	13(24.07)	17(17.17)	1.056	0.304
LODS[分，M(Q₁，Q₃)]	10(6，12)	6(4，9)	4.489	0.000
高血压[n(%)]	22(40.74)	37(37.37)	0.167	0.683
有创机械通气[n(%)]	52(96.30)	70(70.71)	14.162	0.000
SOFA[分，M(Q₁，Q₃)]	15(8，19)	11(8，15)	2.794	0.005
APACHE Ⅱ[分，(±s)]	23.43±6.87	20.88±6.88	2.189	0.030
CRRT[n(%)]	35(64.81)	32(32.32)	14.986	0.000

临床资料	观察组(n＝54)	对照组(n＝99)	χ²/t/Z值	P值
性别[n(%)]			0.782	0.376
男	35(64.81)	71(71.72)
女	19(35.19)	28(28.28)
糖尿病[n(%)]	13(24.07)	17(17.17)	1.056	0.304
LODS[分，M(Q₁，Q₃)]	10(6，12)	6(4，9)	4.489	0.000
高血压[n(%)]	22(40.74)	37(37.37)	0.167	0.683
有创机械通气[n(%)]	52(96.30)	70(70.71)	14.162	0.000
SOFA[分，M(Q₁，Q₃)]	15(8，19)	11(8，15)	2.794	0.005
APACHE Ⅱ[分，(±s)]	23.43±6.87	20.88±6.88	2.189	0.030
CRRT[n(%)]	35(64.81)	32(32.32)	14.986	0.000

实验室指标	观察组(n＝54)	对照组(n＝99)	χ²/t/Z值	P值
血红蛋白(g/L)	90.00(76.50，113.25)	93.00(81.00，120.00)	1.487	0.137
血小板(×10⁹/L)	146.0(74.8，212.3)	145.0(111.0，218.0)	1.080	0.280
D1RDW(%)	15.20(13.80，16.75)	14.40(13.40，16.00)	2.265	0.024
D3RDW(%)	15.6(14.2，17.3)	14.6(13.6，16.1)	2.774	0.006
D5RDW(%)	15.55(14.70，17.88)	14.80(13.70，15.90)	3.655	0.000
D7RDW(%)	15.90(15.08，17.88)	14.60(13.60，15.80)	4.630	0.000
pH	7.35(7.21，7.45)	7.39(7.32，7.44)	1.385	0.166
D二聚体(μg/ml)	4.44(2.42, 9.32)	5.20(2.27，11.90)	0.560	0.576
肌酐(μmol/L)	308.00(116.20，558.50)	170.80(86.00，336.50)	2.388	0.017
白蛋白[g/L，(±s)]	27.55±6.02	28.67±5.687	1.140	0.256
ICU住院时间(d)	15.0(10.0，25.5)	12.0(8.0，22.0)	1.797	0.072
D1 RDW/PLT	0.104(0.075，0.210)	0.095(0.062，0.138)	1.527	0.127
D3 RDW/PLT	0.209(0.114，0.483)	0.129(0.076，0.231)	3.134	0.002
D5 RDW/PLT	0.339(0.154，0.747)	0.113(0.073，0.214)	5.198	0.000
D7 RDW/PLT	0.327(0.144，0.617)	0.085(0.057，0.136)	6.738	0.000

实验室指标	观察组(n＝54)	对照组(n＝99)	χ²/t/Z值	P值
血红蛋白(g/L)	90.00(76.50，113.25)	93.00(81.00，120.00)	1.487	0.137
血小板(×10⁹/L)	146.0(74.8，212.3)	145.0(111.0，218.0)	1.080	0.280
D1RDW(%)	15.20(13.80，16.75)	14.40(13.40，16.00)	2.265	0.024
D3RDW(%)	15.6(14.2，17.3)	14.6(13.6，16.1)	2.774	0.006
D5RDW(%)	15.55(14.70，17.88)	14.80(13.70，15.90)	3.655	0.000
D7RDW(%)	15.90(15.08，17.88)	14.60(13.60，15.80)	4.630	0.000
pH	7.35(7.21，7.45)	7.39(7.32，7.44)	1.385	0.166
D二聚体(μg/ml)	4.44(2.42, 9.32)	5.20(2.27，11.90)	0.560	0.576
肌酐(μmol/L)	308.00(116.20，558.50)	170.80(86.00，336.50)	2.388	0.017
白蛋白[g/L，(±s)]	27.55±6.02	28.67±5.687	1.140	0.256
ICU住院时间(d)	15.0(10.0，25.5)	12.0(8.0，22.0)	1.797	0.072
D1 RDW/PLT	0.104(0.075，0.210)	0.095(0.062，0.138)	1.527	0.127
D3 RDW/PLT	0.209(0.114，0.483)	0.129(0.076，0.231)	3.134	0.002
D5 RDW/PLT	0.339(0.154，0.747)	0.113(0.073，0.214)	5.198	0.000
D7 RDW/PLT	0.327(0.144，0.617)	0.085(0.057，0.136)	6.738	0.000

影响因素	β值	标准误	Wald值	P值	OR值	95%CI
有创机械通气	2.407	0.894	7.244	0.007	11.095	1.923~12.816
APACHEⅡ评分	0.087	0.044	3.886	0.049	0.916	0.840~0.999
D7 RDW	0.370	0.118	9.855	0.002	1.448	1.149~1.825
D7 RDW/PLT	2.082	1.025	4.129	0.042	8.020	1.077~59.744
LODS评分	0.257	0.086	8.840	0.003	1.293	1.091~1.531

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