Baseline red blood cell distribution width and perforin, dynamic levels of interleukin 6 and lactate are predictors of mortality in patients with sepsis

Background Sepsis is a critical illness often encountered in the intensive care unit. However, prognostic biomarkers for sepsis have limited sensitivity. This study aimed to identify more sensitive predictors of mortality through repeated monitoring of laboratory parameters. Methods Patients with sepsis (Sepsis 3.0 criteria met) were recruited and divided into the survivor and nonsurvivor groups after 28 days. Data on blood biochemistry, lymphocyte subsets, and cytokines were obtained on the first and seventh hospitalization days. Univariate and multivariate Cox regression analyses were performed to explore the correlation between these variables and patient mortality. Results Forty patients with sepsis were included. The mortality rate was 37.5%. Red blood cell distribution width‐standard deviation (RDWSD) (hazard ratio [HR] = 1.107 [95% CI: 1.005–1.219], p = 0.040) and perforin level (HR = 1.001 [95% CI: 1–1.003], p = 0.035) on the first day, as well as lactate (HR = 112.064 [95% CI: 2.192–5729.629], p = 0.019) and interleukin 6 (IL‐6) (HR = 1.005 [95% CI: 1.001–1.008], p = 0.014) levels on the seventh day, were independent risk factors of mortality. If the patients were divided into two groups based on RDWSD (normal: n = 31; increased: n = 9), the Kaplan–Meier curves showed that the group with increased RDWSD had a lower survival (p = 0.025). Conclusion Baseline RDWSD and perforin, along with dynamic IL‐6 and lactate levels, were independent predictors of mortality in patients with sepsis. This study aimed to identify the biomarkers of sepsis prognosis showing higher sensitivity through repeated monitoring of relevant laboratory data and to conduct a multifactor regression analysis to assess the risk factors of 28‐day mortality. Forty patients with sepsis who were admitted to the medical intensive care unit were included. Patients were subsequently divided into the survivor and nonsurvivor groups based on their 28‐day survival. We found that baseline red blood cell distribution width‐standard deviation was an independent predictor of 28‐day mortality in patients with sepsis. In addition, the baseline perforin level, as well as dynamic observation of interleukin 6 and lactate levels, may be more physiologically relevant than simply focusing on clinical features.