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.