Emergency Department, Affiliated Zhejiang Hospital of Zhejiang University School of Medical, Hangzhou, Zhejiang, China.
J Clin Lab Anal. 2022 May;36(5):e24378. doi: 10.1002/jcla.24378. Epub 2022 Mar 31.
The purpose of this study was to investigate whether platelet count was associated with mortality in acute respiratory distress syndrome (ARDS) patients.
We analyzed patients with ARDS from Multi-parameter Intelligent Monitoring in Intensive Care Database III (MIMIC-III). Platelet count was measured at the time of intensive care unit (ICU) admission. The cox proportional hazard model and subgroup analysis were used to determine the relationship between the platelet count and mortality of ARDS, as well as the consistency of its association. The primary outcome of this study was 365-day mortality from the date of ICU admission.
This study enrolled a total of 395 critically ill patients with ARDS. After adjustment for age, gender and ethnicity, the multivariate cox regression model showed that the hazard ratios (HRs) (95% confidence intervals [CIs]) of platelet count <192 × 10 /L and >296 × 10 /L were 2.08 (1.43, 3.04) and 1.35 (0.91, 2.01), respectively, compared with the reference (192-296 ×10 /L). After adjusting for confounding factors, lower platelet count (<192 × 10 /L) was associated with increased mortality (adjusted HR, 1.71; 95% CI 1.06-2.76, p = 0.0284). However, there was no similar trend in the 30-day (adjusted HR,1.02; 95% CI 0.54-1.94) or 90-day (adjusted HR, 1.65; 95% CI 0.94-2.89) mortality. In the subgroup analysis, lower platelet count showed significant interactions with specific populations (p interaction = 0.0413), especially in patients with atrial fibrillation.
Taken together, our analysis showed that platelet count is an independent predictor of mortality in critically ill patients with ARDS.
本研究旨在探讨血小板计数与急性呼吸窘迫综合征（ARDS）患者死亡率之间的关系。
我们分析了来自多参数智能监护重症监护数据库 III（MIMIC-III）的 ARDS 患者。血小板计数在入住重症监护病房（ICU）时进行测量。采用 Cox 比例风险模型和亚组分析来确定血小板计数与 ARDS 死亡率之间的关系及其相关性的一致性。本研究的主要结局是从 ICU 入住日期起的 365 天死亡率。
本研究共纳入了 395 例重症 ARDS 患者。在调整年龄、性别和种族后，多变量 Cox 回归模型显示，血小板计数 <192×10/L 和 >296×10/L 的危险比（HR）（95%置信区间[CI]）分别为 2.08（1.43，3.04）和 1.35（0.91，2.01），与参考值（192-296×10/L）相比。在调整混杂因素后，较低的血小板计数（<192×10/L）与死亡率增加相关（调整 HR，1.71；95%CI 1.06-2.76，p=0.0284）。然而，在 30 天（调整 HR，1.02；95%CI 0.54-1.94）或 90 天（调整 HR，1.65；95%CI 0.94-2.89）死亡率方面没有类似的趋势。在亚组分析中，较低的血小板计数与特定人群（p 交互=0.0413）表现出显著的交互作用，特别是在心房颤动患者中。
综上所述，我们的分析表明，血小板计数是重症 ARDS 患者死亡率的独立预测因子。
