Predictive values of erythrocyte and platelet parameters for the severity of sepsis in children

Objective　To evaluate the predictive values of erythrocyte and platelet parameters for the severity of sepsis in children. Methods　A total of 213 children with sepsis admitted to Pediatric Intensive Care Unit (PICU) of Hebei Children's Hospital from December 2015 to December 2020 were selected as the research subjects. According to the severity, they were divided into the sepsis group (152 cases) and septic shock group (61 cases). The gender, age, infected site and treatment of the enrolled subjects were recorded. The erythrocyte and platelet parameters were collected within 24 hours after the diagnosis of sepsis. The children were scored according to acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure score (SOFA) within 24 hours after admission to PICU. The median of the red cell volume distribution width (RDW) and platelet distribution width (PDW) and interquartile range were calculated for the child patients using the quartile method, and the 213 child patients were stratified on the basis. The gender, age, length of PICU stay, continuous renal replacement therapy (CRRT), mechanical ventilation, and occurrence of septic shock were compared between the child patients with different RDW and PDW stratifications. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of erythrocyte and platelet parameters for the severity of children with sepsis. Results　The scores of RDW [17.03%(16.17%, 18.72%)], PDW [24.25 fl (23.25 fl, 26.60 fl)], APACHE Ⅱ (19.06±3.78) and SOFA (7.35±2.62) in septic shock group were higher than those [15.28%(14.23%, 16.39%), 21.28 fl (18.84 fl, 23.40 fl), 15.73±3.89, 5.68±2.40] in sepsis group, with statistical significance (P<0.05). There was statistically significant difference in the duration of assisted ventilation for RDW stratification (P<0.05), and there was statistically significant difference in the duration of hospitalization in PICU for PDW stratification (P<0.05). There was statistical significance in sepsis severity between RDW stratification and PDW stratification (P<0.05). RDW had the highest predictive value for sepsis severity, while PDW had the highest sensitivity for sepsis severity. Conclusion　RDW and PDW are important biomarkers for predicting the severity of sepsis in children. DOI: 10.11855/j.issn.0577-7402.2021.09.12