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危重症患者的血小板减少症:临床与实验室表现及其与住院期间短期预后的相关性

Thrombocytopenia in Critically Ill Patients: Clinical and Laboratorial Behavior and Its Correlation with Short-term Outcome during Hospitalization.

作者信息

Khurana Divya, Deoke Shilpa A

机构信息

MBBS Intern, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.

Department of Medicine, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2017 Dec;21(12):861-864. doi: 10.4103/ijccm.IJCCM_279_17.

Abstract

BACKGROUND

Thrombocytopenia, being among the most common laboratory abnormality, found in Intensive Care Unit (ICU) patients is commonly associated with sepsis and disseminated intravascular coagulation. Declining platelet counts are associated with higher mortality rates. Thus, thrombocytopenia can be used as a prognostic marker in critically ill patients.

METHODOLOGY

A prospective observational study was conducted on patients fulfilling the inclusion criteria and were evaluated for complete medical history, clinical, and laboratorial examination. Short-term outcome of the patient was correlated with thrombocytopenia.

RESULTS

The incidence of thrombocytopenia in ICU patients was 37.57%, and mortality was 44%. Higher mortality rate was found among patients with acute febrile illnesses, respiratory diseases, and sepsis ( = 0.08, 0.22, 0.41 respectively). The mortality was higher in patients with platelet counts <100,000/μl ( = 0.0008) and whose platelet levels declined on day 3 or 5 ( = 0.0001).

CONCLUSIONS

Low as well as declining platelet counts are markers of severity of critical patients and are directly related to prognosis and mortality of patients in ICU.

摘要

背景

血小板减少症是重症监护病房(ICU)患者中最常见的实验室异常之一,通常与脓毒症和弥散性血管内凝血相关。血小板计数下降与较高的死亡率相关。因此,血小板减少症可作为危重症患者的预后标志物。

方法

对符合纳入标准的患者进行前瞻性观察研究,并对其完整的病史、临床和实验室检查进行评估。患者的短期预后与血小板减少症相关。

结果

ICU患者血小板减少症的发生率为37.57%,死亡率为44%。急性发热性疾病、呼吸系统疾病和脓毒症患者的死亡率较高(分别为=0.08、0.22、0.41)。血小板计数<100,000/μl的患者死亡率较高(=0.0008),且在第3天或第5天血小板水平下降的患者死亡率较高(=0.0001)。

结论

血小板计数低以及血小板计数下降是危重症患者病情严重程度的标志物,且与ICU患者的预后和死亡率直接相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d33/5752797/395442c44ff3/IJCCM-21-861-g002.jpg

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