A retrospective cohort study examined 2,226 patients with sepsis admitted to an intensive care unit between 2014 and 2015, recording 328 deaths within 28 days of hospitalization. Research has focused on the ratio of red blood cell distribution width to platelet count (RPR) as a potential biomarker of sepsis prognosis. During the first six days after admission, the RPR gradually decreased and stabilized in patients who survived, whereas there was a significant early increase in the ratio in patients who died. The difference in RPR between survivors and nonsurvivors increased at an average rate of 1.75 units per day. Even after adjusting for various influencing factors, this dynamic trend remained statistically significant. The authors concluded that an early increase in RPR in the early stage of sepsis is associated with a higher risk of hospitalization and that longitudinal trajectories of RPR may provide additional information for risk stratification in septic patients.