PROGNOSTIC VALUE OF THE PLATELET-TO-LYMPHOCYTE RATIO IN SEPSIS

Abstract

Background: The complete blood count is a widely utilized and easily accessible laboratory test performed in most healthcare facilities, providing valuable information regarding inflammation, anemia, and hemostasis. Among the hematologic indices, the platelet-to-lymphocyte ratio (PLR)—calculated as the platelet count divided by the lymphocyte count—has been recognized as a useful prognostic biomarker in various diseases, including cardiovascular disorders, renal disease, and malignancies. This study aimed to determine whether elevated PLR values are associated with an increased risk of mortality in patients with sepsis.

Objectives: To evaluate the prognostic value of PLR measured within the first 24 hours of hospital admission in predicting short-term all-cause mortality among patients with sepsis.

Methods: We conducted a retrospective cohort study by reviewing medical records of patients diagnosed with sepsis or septic shock admitted to the Emergency Department-Dong Nai General Hospital between August 2024 and August 2025. The primary outcome was 30-day all-cause mortality.

Results: 160 deaths were registered, accounting for 48% of the cohort. The area under the ROC curve (AUC) for PLR in predicting 30-day mortality was 0.611 (95% CI: 0.551–0.671, p <0.001). The optimal cut-off value for PLR stratification was 245.5. In multivariate logistic regression analysis, PLR remained an independent predictor of mortality (OR: 1.002, 95% CI: 1.001–1.003, p = 0.001).

Conclusions: PLR demonstrates potential prognostic value in predicting short-term mortality in patients with sepsis. Higher PLR levels are correlated with an increased risk of death, indicating its potential utility as a simple and accessible tool for risk stratification and guiding clinical decision-making in sepsis management.

Keywords: platelet-to-lymphocyte ratio; sepsis; septic shock; prognosis