血小板减少症对因严重社区获得性肺炎入住重症监护病房患者预后的影响。

Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia.

作者信息

Brogly Nicolas, Devos Patrick, Boussekey Nicolas, Georges Hugues, Chiche Arnaud, Leroy Olivier

机构信息

Service de Réanimation Médicale et Maladies Infectieuses, Université de Lille, Hôpital G. Chatiliez, 135 rue du Président Coty, 59208 Tourcoing, France.

出版信息

J Infect. 2007 Aug;55(2):136-40. doi: 10.1016/j.jinf.2007.01.011. Epub 2007 Mar 9.

DOI:10.1016/j.jinf.2007.01.011

PMID:17350105

Abstract

OBJECTIVE

To evaluate the prevalence and the prognostic value of thrombocytopenia in patients admitted to ICU for severe community-acquired pneumonia.

METHODS

Multicentre observational study was conducted in 7 ICUs in the north of France over a 19-year period (1987-2005). The primary outcome measure was the ICU mortality.

RESULTS

Eight hundred and twenty-two patients were studied. A platelet count < 150x10(9)/L was observed at ICU admission in 202 (25%) patients. Admission platelet count was between 101 and 149x10(9)/L, 51 and 100x10(9)/L, 21 and 50x10(9)/L, and < or = 20x10(9)/L in 100, 61, 32 and 9 patients, respectively. ICU mortality rate was 35.4%. Classifying patients into 3 categories with the following cut-offs of platelet count, > or = 150x10(9)/L, 51-149x10(9)/L, and < or = 50x10(9)/L, we observed a significant increase in ICU mortality rates which were 30.8% in the first group, 44.1% in the second group and 70.7% in the last one (p<0.0001). In multivariate analysis, thrombocytopenia < or = 50x10(9)/L appeared as an independent predictor of mortality (AOR=4.386).

CONCLUSIONS

In patients admitted to ICU for severe community-acquired pneumonia, thrombocytopenia has a high prevalence and influences the outcome.

摘要

目的

评估因严重社区获得性肺炎入住重症监护病房（ICU）患者血小板减少症的患病率及其预后价值。

方法

在法国北部的7个ICU进行了为期19年（1987 - 2005年）的多中心观察性研究。主要结局指标是ICU死亡率。

结果

共研究了822例患者。202例（25%）患者在ICU入院时血小板计数<150×10⁹/L。入院时血小板计数在101至149×10⁹/L、51至100×10⁹/L、21至50×10⁹/L以及≤20×10⁹/L的患者分别有100例、61例、32例和9例。ICU死亡率为35.4%。将患者按血小板计数的以下临界值分为3类，≥150×10⁹/L、51 - 149×10⁹/L和≤50×10⁹/L，我们观察到ICU死亡率显著增加，第一组为30.8%，第二组为44.1%，最后一组为70.7%（p<0.0001）。在多变量分析中，血小板减少症≤50×10⁹/L是死亡率的独立预测因素（比值比=۴.۳۸۶）。