Correlation analysis of peripheral blood CRP/PCT ratio,MLR and disease outcome in burn patients with sepsis-associated ARDS

Wei Jianyu; Yin Zongqi; Gao Min; Pan Qing; Zhang Xinyi; Chen Yufan; Luo Zhizhen

doi:10.11986/j.issn.1673-873X.2025.11.12

Abstract：Objective To analyze the correlation between peripheral blood C-reactive protein/procalcitonin(CRP/PCT)ratio,monocyte/lymphocyte ratio(MLR),and disease outcome in burn patients with sepsis-associated acute respiratory distress syndrome(ARDS),aiming to provide a reference for clinical decision-making.Methods A total of 202 burn patients with sepsis-associated ARDS admitted to our hospital from January 2020 to December 2024 were included and followed continu-ously for 1 month.According to disease outcome,they were divided into a death group(n=79)and a survival group(n=123).Receiver operating characteristic(ROC)curves were used to assess the predictive value of peripheral blood CRP/PCT ratio and MLR for disease outcome among these participants;multivariate stepwise logistic regression was used to analyze prognostic factors.Results The death group had significantly higher peripheral blood CRP/PCT ratio and MLR than the survival group(P＜0.05).Univariate analysis showed that proportions of patients aged ≥60 years,septic shock,and se-vere ARDS were greater in the death group;the death group had higher admission Sequential Organ Failure Assessment(SOFA)and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,higher CRP,procalcitonin(PCT)and monocyte(MN)levels,longer duration of mechanical ventilation,and lower lymphocyte(LYM)levels than the survival group,with statistically significant differences(P＜0.05).Multivariate logistic regression analysis indicated that higher ad-mission APACHE Ⅱ score(OR=2.020,95％CI:1.433-2.846),longer duration of mechanical ventilation(OR=2.401,95％CI:1.594-3.617),CRP/PCT ratio ≥18.99(OR=3.019,95％CI:1.939-4.702)and MLR ≥0.56(OR=2.524,95％CI:1.669-3.817)were risk factors for death in burn patients with sepsis-associated ARDS(P＜0.05).The AUCs of peripheral blood CRP/PCT ratio and MLR for predicting disease outcome were 0.867 and 0.759,re-spectively,both lower than the AUC of the combined prediction(AUC=0.916)and the AUC of the logistic model com-bined prediction(AUC=0.903).DeLong test showed that the predictive performance of the two combined approaches was significantly superior to single indicators(combined vs.CRP/PCT:Z=2.303,P=0.021;combined vs.MLR:Z=5.927,P＜0.001;logistic model vs.CRP/PCT:Z=2.130,P=0.033;logistic model vs.MLR:Z=5.754,P＜0.001),while there was no significant difference between the two combined approaches(Z=0.138,P=0.891).Conclusion Elevations of peripheral blood CRP/PCT ratio and MLR are associated with increased risk of death in burn patients with sepsis-associat-ed ARDS and can serve as important predictors of disease outcome.