Clinical significance of red cell distribution width (rdw) and circulating neutrophil - lymphocyte count ratio (nlcr) as prognostic markers in sepsis

A study on establishing the role of RDW and NLCR as biomarkers for the early detection of sepsis, severe sepsis and septic shock and in prediction of outcome was conducted. A total of 85 subjects meeting the inclusion and exclusion criteria and diagnosed with mild sepsis, severe sepsis and septic shock were selected. After a thorough clinical examination, blood sampling was done for all the subjects, within 3 hours of presenting the illness. The values of RDW and NLCR were studied on the day of admission, after 72 hours and after 7 days. Statistical studies were done by SPSS software and analyzed by unpaired t test, chi-square test and Pearson’s correlation coefficient. After analysis, we found that in patients of severe sepsis and septic shock class, in survivor and non-survivor group, significant elevation of RDW and NLCR was found. The cut off values of RDW and NLCR in predicting the mortality in 95% confidential interval were calculated. There was a good correlation of SOFA score with NLCR and RDW in predicting the 28 days outcome. The study revealed that RDW and NLR can be used as potential markers for early detection of severe sepsis and septic shock and in predicting the outcome