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血小板指标是重症监护病房患者医院死亡率的新型预测指标。

Platelet indices are novel predictors of hospital mortality in intensive care unit patients.

作者信息

Zhang Zhongheng, Xu Xiao, Ni Hongying, Deng Hongsheng

机构信息

Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China.

Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China.

出版信息

J Crit Care. 2014 Oct;29(5):885.e1-6. doi: 10.1016/j.jcrc.2014.04.020. Epub 2014 May 9.

Abstract

BACKGROUND AND OBJECTIVE

Platelet volume indices (PVIs) are inexpensive and readily available in intensive care units (ICUs). However, their association with mortality has never been investigated in a critical care setting. Our study aimed to investigate the association of PVI and mortality in unselected ICU patients.

METHODS

This was a retrospective study conducted in a mixed 24-bed ICU from September 2010 to December 2012. Platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), platelet count, and plateletcrit were measured on ICU entry. Univariable analyses were performed to screen for variables that were associated with mortality. Variables with P < .1 were incorporated into a regression model to adjust for the odds ratio of platelet indices.

RESULTS

A total of 1556 patients were included during the study period, including 1113 survivors and 443 nonsurvivors (mortality rate: 28.47%). Platelet distribution width and MPV were significantly higher in nonsurvivors than in survivors. Platelet distribution width greater than 17% and MPV greater than 11.3 fL were independent risk factors for mortality (adjusted odds ratio: 1.92 and 1.84, respectively) and survival time (hazards ratio: 1.77 and 1.75, respectively).

CONCLUSION

Higher MPV and PDW are associated with increased risk of death, whereas the decrease in plateletcrit is associated with increased mortality risk.

摘要

背景与目的

血小板体积指标(PVIs)成本低廉,在重症监护病房(ICU)中易于获取。然而,在重症监护环境中,其与死亡率的关联从未得到研究。我们的研究旨在调查未经过筛选的ICU患者中PVI与死亡率之间的关联。

方法

这是一项回顾性研究,于2010年9月至2012年12月在一家拥有24张床位的综合性ICU中进行。在患者进入ICU时测量血小板指标,包括平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板计数和血小板压积。进行单变量分析以筛选与死亡率相关的变量。P < 0.1的变量被纳入回归模型,以调整血小板指标的比值比。

结果

研究期间共纳入1556例患者,其中1113例存活,443例未存活(死亡率:28.47%)。未存活者的血小板分布宽度和MPV显著高于存活者。血小板分布宽度大于17%和MPV大于11.3 fL是死亡率(调整后的比值比分别为1.92和1.84)和生存时间(风险比分别为1.77和1.75)的独立危险因素。

结论

较高的MPV和PDW与死亡风险增加相关,而血小板压积降低与死亡风险增加相关。

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