Construction of a nomogram model for predicting the risk of disseminated intravascular coagulation in sepsis patients based on NPR,PLR,and SII
Batimahan Sulaiman
Leitingru
Mao Yuting
Baoyixiamu Ababaikeli
Kebinuer Tuerxun-jiang
Abstract：Objective To construct and validate a risk prediction model for disseminated intravascular coagulation(DIC)in sepsis patients based on neutrophil-to-platelet ratio(NPR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII).Methods A retrospective study was conducted on 353 sepsis patients admitted to the Infectious Disease and Liver Disease Center of the First Affiliated Hospital of Xinjiang Medical University from December 2022 to De-cember 2024.According to DIC occurrence,patients were divided into DIC group(n=58)and non-DIC group(n=295).Mult-ivariate logistic regression analysis was used to identify independent risk factors for DIC in sepsis patients,and a nomogram prediction model was constructed based on NPR,PLR,SII,and other significant factors.The model's predictive performance was evaluated using receiver operating characteristic(ROC)curve and area under the curve(AUC),while the calibration curve assessed model fit.Results Among 353 sepsis patients,58 developed DIC,with an incidence of 16.4％.Compared with the non-DIC group,the DIC group showed significantly higher values in:mean age,proportion with diabetes history,pulmonary infections,bloodstream infections,SOFA score,APACHE Ⅱ score,shock incidence,vasoactive drug use,mechanical ventila-tion rate,renal replacement therapy rate,NPR,SII,prothrombin time(PT),activated partial thromboplastin time(APTT),and D-dimer(D-D).Conversely,PLR and fibrinogen(FIB)were significantly lower in the DIC group(x2/t/P=2.367/0.018,4.173/0.041,4.062/0.044,4.053/0.044,2.412/0.016,2.757/0.006,4.109/0.043,4.538/0.033,4.04/0.044,4.304/0.038,4.735/＜0.001,-4.158/＜0.001,3.812/＜0.001,2.622/0.009,2.662/0.008,-3.696/＜0.001,3.221/0.001).Multivariate analysis identified older age,higher SOFA score,higher APACHE Ⅱ score,elevated NPR,elevated SII,and prolonged PT as independent risk factors for DIC,while higher PLR and FIB were protective factors[OR(95％CI)=1.091(1.013-1.175),3.807(1.616-8.967),1.183(1.050-1.333),4.680(2.080-6.092),0.980(0.969-0.991),1.001(1.000-1.003),1.050(1.008-1.094),0.501(0.301-0.833)].The ROC analysis showed an AUC of 0.821(95％CI:0.715-0.868)for DIC prediction.The calibration curve indica-ted good model fit(Hosmer-Lemeshow x2=6.400,P=0.603).Conclusion The age,SOFA score,APACHE Ⅱ score,NPR,PLR,SII,PT,and fibrinogen are associated with DIC in sepsis patients.The nomogram model incorporating NPR,PLR,SII,and other relevant indicators demonstrates high predictive value for DIC risk in sepsis patients.
Keywords：SepsisDisseminated intravascular coagulationNeutrophil-to-Platelet ratioPlatelet-to-Lymphocyte ratioSystemic immune-inflammation indexNomogram
Publication Date：2025-11-18
Online Publishing Date：2025-12-05(First online date of this platform, not the publication date of the document)
Pages：6( 1347-1352 )