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 (<i>n</i> = 157) and non-survivor (<i>n</i> = 80) groups based on 28-day outcomes. Intergroup comparison, receiver operating characteristic (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, <i>p</i> < 0.001), day 7 (1.40 vs 0.29, <i>p</i> < 0.001), and change degree (0.44 vs -0.31, <i>p</i> < 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.