• Yan Gao, Yao Chen, and Li Gao.
• Intensive Care Unit, The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi, China.
• Brit J Hosp Med. 2024 Dec 30; 85 (12): 1121-12.

AbstractAims/Background Sepsis is a life-threatening condition resulting from dysregulated immune responses to infection, leading to organ dysfunction. High-density lipoprotein (HDL) and red cell distribution width (RDW) have shown significant correlations with sepsis severity, yet the combined prognostic value of HDL and RDW in evaluating sepsis severity and outcomes remains unclear. This study examines the relationship between HDL and RDW levels and sepsis severity, as well as evaluates the combined utility of these markers in predicting disease severity and patient outcomes. Methods This retrospective study included 103 patients diagnosed with sepsis. Clinical data, including HDL and RDW levels, were collected for analysis. Patients were divided into shock and non-shock groups based on the presence of septic shock and into survival and death groups based on 30-day in-hospital mortality. Multivariate logistic regression was used to identify factors influencing sepsis severity and prognosis, while the predictive value of HDL in combination with RDW was evaluated using receiver operating characteristic (ROC) curve analysis. Results Multivariate analysis identified sequential organ failure assessment (SOFA) score (OR = 6.566), interleukin-6 (IL-6) (OR = 2.568), HDL (OR = 0.864), and RDW (OR = 4.052) as independent predictors of sepsis severity (p < 0.05 for all). ROC analysis demonstrated that HDL combined with RDW yielded the highest diagnostic accuracy for sepsis severity, with an area under curve (AUC) of 0.962, sensitivity of 97.56%, and specificity of 91.94%. Additionally, SOFA score (OR = 2.354), interleukin-6 (IL-6) (OR = 1.446), HDL (OR = 0.870), and RDW (OR = 3.502) were independent prognostic indicators (p < 0.05 for all). ROC analysis for prognosis showed that HDL combined with RDW had the highest predictive efficacy for the prognosis of sepsis, with an AUC of 0.922, sensitivity of 79.31%, and specificity of 93.24%. Conclusion The combination of HDL and RDW is a robust indicator for the evaluation of sepsis severity and is a valuable prognostic tool for assessing 30-day mortality risk in sepsis patients.

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