Abstract
BACKGROUND: Sepsis is a highly heterogeneous clinical syndrome, and the real-time prognosis prediction and risk stratification for it remain a big challenge in current clinical research. This study aimed to assess the performance of IL-10/lymphocyte ratio (ILR) and lactate (Lac) in the prognostic prediction and risk stratification of sepsis. METHODS: This is a retrospective observational study that included 148 patients with sepsis admitted to the First Affiliated Hospital of Chongqing Medical University from January 2022 to February 2023. Data collection commenced on the first day of ICU admission, with clinical and laboratory parameters recorded within 24 h of diagnosis, including IL-10 levels, lymphocyte counts, Lac, SOFA score, and APACHE II score. The relationship between ILR and Lac and 28-day mortality were analyzed by multivariate logistic regression analysis and Cox proportional hazards regression, and their predictive efficacy were assessed by receiver operator characteristic curves (ROCs), and Kaplan-Meier survival curves were used to validate the effect of risk stratification. RESULTS: Patients in the death group exhibited significantly higher ILR (302.33 vs. 16.37) and Lac levels (3.25 mmol/L vs. 1.90 mmol/L) compared to the survival group (both p < 0.001). Multivariate logistic regression analysis showed that ILR (OR = 1.005, 95% CI 1.001-1.009) was independent risk factor for death at 28 days. Analysis of ROCs showed that the predictive efficacy of ILR (AUC = 0.860) was superior to the APACHE II score (AUC = 0.797) and the SOFA score (AUC = 0.704). Based on stratification by ILR (cutoff value 97.4) and Lac (cutoff value 4.1 mmol/L), the four risk stratification levels (Levels I-IV) exhibited progressively decreasing 28-day mortality rates: Level I (78.95%), Level II (50.00%), Level III (15.38%), and Level IV (7.69%). Kaplan-Meier analysis confirmed significant survival differences (p < 0.001), with Level I demonstrating the worst prognosis. CONCLUSION: The combined ILR and Lac measurement provides a practical bedside tool for real-time sepsis risk stratification, demonstrating better prognostic utility than conventional scoring systems while maintaining clinical feasibility.