From the Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany.
ASAIO J. 2024 Jan 1;70(1):44-52. doi: 10.1097/MAT.0000000000002066. Epub 2023 Oct 12.
The study investigates the prognostic value of the platelet count in patients with cardiogenic shock (CS). Limited data regarding the prognostic value of platelets in patients suffering from CS is available. Consecutive patients with CS from 2019 to 2021 were included at one institution. Firstly, the prognostic value of the baseline platelet count was tested for 30-day all-cause mortality. Thereafter, the prognostic impact of platelet decline during course of intensive care unit (ICU) hospitalization was assessed. A total of 249 CS patients were included with a median platelet count of 224 × 10 6 /ml. No association of the baseline platelet count with the risk of 30-day all-cause mortality was found (log-rank p = 0.563; hazard ratio [HR] = 0.879; 95% confidence interval [CI] 0.557-1.387; p = 0.579). In contrast, a decrease of platelet count by ≥ 25% from day 1 to day 3 was associated with an increased risk of 30-day all-cause mortality (55% vs. 39%; log-rank p = 0.045; HR = 1.585; 95% CI 0.996-2.521; p = 0.052), which was still evident after multivariable adjustment (HR = 1.951; 95% CI 1.116-3.412; p = 0.019). Platelet decrease during the course of ICU hospitalization but not the baseline platelet count was associated with an increased risk of 30-day all-cause mortality in CS patients.
这项研究调查了血小板计数在心源性休克(CS)患者中的预后价值。目前关于 CS 患者血小板预后价值的相关数据有限。该研究在一家机构中连续纳入了 2019 年至 2021 年期间患有 CS 的患者。首先,测试了基线血小板计数对 30 天全因死亡率的预后价值。然后,评估了 ICU 住院期间血小板下降对预后的影响。共纳入 249 例 CS 患者,中位血小板计数为 224×106/ml。基线血小板计数与 30 天全因死亡率风险之间无相关性(对数秩检验 p=0.563;风险比[HR] = 0.879;95%置信区间[CI] 0.557-1.387;p=0.579)。相反,从第 1 天到第 3 天血小板计数下降≥25%与 30 天全因死亡率风险增加相关(55% vs. 39%;对数秩检验 p=0.045;HR = 1.585;95%CI 0.996-2.521;p=0.052),即使在多变量调整后仍然如此(HR = 1.951;95%CI 1.116-3.412;p=0.019)。CS 患者 ICU 住院期间血小板下降与 30 天全因死亡率风险增加相关,而基线血小板计数则无此相关性。