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血小板参数与 2019 年冠状病毒病患者死亡率的相关性:回顾性队列研究。

Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study.

机构信息

Intensive Care Unit, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China.

Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China.

出版信息

Platelets. 2020 May 18;31(4):490-496. doi: 10.1080/09537104.2020.1754383. Epub 2020 Apr 16.

Abstract

BACKGROUND

Thrombocytopenia has been implicated in patients infected with severe acute respiratory syndrome coronavirus 2, while the association of platelet count and changes with subsequent mortality remains unclear.

METHODS

The clinical and laboratory data of 383 patients with the definite outcome by March 1, 2020 in the Central Hospital of Wuhan were reviewed. The association between platelet parameters and mortality risk was estimated by utilizing Cox proportional hazard regression models.

RESULTS

Among the 383 patients, 334 (87.2%) were discharged and survived, and 49 (12.8%) died. Thrombocytopenia at admission was associated with mortality of almost three times as high as that for those without thrombocytopenia ( < 0.05). Cox regression analyses revealed that platelet count was an independent risk factor associated with in-hospital mortality in a dose-dependent manner. An increment of per 50 × 10/L in platelets was associated with a 40% decrease in mortality (hazard ratio: 0.60, 95%CI: 0.43, 0.84). Dynamic changes of platelets were also closely related to death during hospitalization.

CONCLUSIONS

Baseline platelet levels and changes were associated with subsequent mortality. Monitoring platelets during hospitalization may be important in the prognosis of patients with coronavirus disease in 2019.

摘要

背景

血小板减少与严重急性呼吸综合征冠状病毒 2 感染的患者有关,而血小板计数的变化与随后的死亡率之间的关系尚不清楚。

方法

回顾了 2020 年 3 月 1 日前在武汉市中心医院明确结局的 383 例患者的临床和实验室数据。利用 Cox 比例风险回归模型评估血小板参数与死亡风险的相关性。

结果

在 383 例患者中,334 例(87.2%)出院并存活,49 例(12.8%)死亡。入院时的血小板减少症与死亡率几乎高出三倍,与无血小板减少症的患者相比(<0.05)。Cox 回归分析显示,血小板计数是与住院死亡率相关的独立危险因素,呈剂量依赖性。血小板每增加 50×10/L,死亡率降低 40%(危险比:0.60,95%CI:0.43,0.84)。血小板的动态变化也与住院期间的死亡密切相关。

结论

基线血小板水平和变化与随后的死亡率有关。住院期间监测血小板可能对 2019 年冠状病毒病患者的预后很重要。

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