EXPRESS: The Predictive Value of C-reactive Protein Combined with Platelets for the Progression and Prognosis of Sepsis: A Retrospective Cohort Study

This retrospective cohort study aimed to explore the predictive value of the C-reactive protein (CRP)/platelet count (PLT) ratio for sepsis progression and prognosis. A total of 237 sepsis patients admitted to the ICU between January 2019 and November 2024 were divided into survivor (n=157) and non-survivor (n=80) groups based on 28-day outcomes. Intergroup comparison, ROC curve analysis, survival analysis, LASSO regression analysis, and Cox regression analysis were employed to evaluate the impact of clinical data, dynamic CRP/PLT ratios (on days 1 and 7), and change degree [(CRP/PLT day 7 − CRP/PLT day 1)/CRP/PLT day 1] on the progression and prognosis of sepsis. The non-survivor group showed significantly higher CRP/PLT ratios on day 1 (0.80 vs. 0.39, P<0.001), day 7 (1.40 vs. 0.29, P<0.001), and change degree (0.44 vs. -0.31, P<0.001) compared to the survivor group. Time-dependent ROC analysis revealed the CRP/PLT ratio on day 7 had the highest prognostic accuracy for short-term mortality (AUC = 0.819). After LASSO selection and multivariable adjustment, CRP/PLT ratio on day 7> 0.51 (HR=2.21, 95% CI: 1.17, 4.15) and change degree > -0.04 (HR=1.89, 95% CI: 1.06, 3.38) remained significant prognostic factors for mortality. These findings suggest the CRP/PLT ratio, particularly on day 7 and the change degree, can serve as effective indicators for the early assessment of mortality risk in sepsis patients, aiding clinical prognosis and treatment adjustment.