Red blood cell distribution width to platelet ratio in neonatal foals with sepsis
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Three hundred seventeen hospitalized neonatal foals ≤7 days of age were retrospectively included.
Rapid and accurate markers to aid diagnosis of sepsis are needed in neonatal foals. The CBC variable red blood cell distribution width (RDW) to platelet ratio (RPR) is associated with inflammatory response and linked to poor outcomes of sepsis in human patients. The aim of this study was to explore the correlation of RPR with sepsis in neonatal foals and evaluate RPR predictive and prognostic value.
Three hundred seventeen hospitalized neonatal foals ≤7 days of age were retrospectively included. Clinical records were used to calculate sepsis scores and define groups. Red blood cell distribution width to platelet ratio was calculated and compared between groups (septic vs nonseptic) based on Kruskal-Wallis and Wilcoxon signed-rank tests. A multivariate logistic regression model to predict sepsis was created. The cutoff for RPR was obtained based on the maximal Youden Index. The Kaplan-Meier method and the log-rank test were used to estimate survival curves and compare survival rates based on RPR.
Results showed that red blood cell distribution width to platelet ratio was significantly higher in septic foals (Median = 0.099, confidence interval [CI] [0.093; 0.108]) than in sick nonseptic (0.085, CI [0.083; 0.089]) and healthy foals (0.081, CI [0.077; 0.086]; P < .0001). Red blood cell distribution width to platelet ratio was able to predict sepsis with high accuracy (AUC = 82.1%). The optimal RPR cutoff for sepsis was 0.09.
In conclusion, red blood cell distribution width to platelet ratio calculation is practical, inexpensive, and based on CBC-derived data. Calculation of RPR along with CBC can aid in the diagnosis of sepsis and estimation of outcome.
“Red blood cell distribution width to platelet ratio in neonatal foals with sepsis” Rebeca Scalco, et al. J Vet Intern Med. 2023 Jun 12. doi: 10.1111/jvim.16793.
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