Predictive value of peripheral blood indicators plus procalcitonin clearance rate for mortality in cancer patients with sepsis.

Abstract

This study investigated the predictive value of combining peripheral blood indicators with procalcitonin clearance rate (PCTc) to assess mortality risk in cancer patients with sepsis, aiming to develop a more sensitive and specific clinical tool. A retrospective analysis was conducted on 393 cancer patients with sepsis admitted to South China Hospital of Shenzhen University from January 2019 to January 2024. Collected data included clinical demographics, laboratory indicators such as white blood cell count, neutrophil count (NEUT), platelet count (PLT), lymphocyte count (LYC), C-reactive protein, procalcitonin (PCT), alanine aminotransferase, and the ratio of arterial oxygen partial pressure to inspired oxygen fraction, as well as functional scores like Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment. Multivariate logistic regression and receiver operating characteristic curves assessed the predictive ability of these factors for 28-day survival. Results showed significantly higher NEUT (P<0.001) and lower PLT and LYC (P<0.001) in the death group, while APACHE II score (area under the curve (AUC) = 0.776) and PCT 24h (AUC = 0.723) demonstrated strong predictive value for mortality risk. The joint projection model's AUC reached 0.966, significantly outperforming individual indicators, indicating that combining multiple indicators offers a more accurate prediction of survival versus mortality risk. Additionally, 24h LCR and 24h PCTc were notably lower in the death group compared to the survival group, reinforcing the advantage of combined indicators for prognosis. Overall, using both peripheral blood indicators and PCTc significantly improves the accuracy of mortality risk assessment in cancer patients with sepsis, enhancing prognostic evaluation and supporting optimized clinical decision-making.