Department of Emergency Medicine, Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518035, China.
Department of Nephrology, Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518035, China.
Eur J Med Res. 2024 Jun 8;29(1):312. doi: 10.1186/s40001-024-01909-1.
Limited evidence exists regarding the link between platelet count and 30-day in-hospital mortality in acute respiratory failure (ARF) patients. Thus, this study aims to investigate this association among ICU patients experiencing acute respiratory failure.
We conducted a retrospective cohort study across multiple centers, utilizing data from the US eICU-CRD v2.0 database covering 22,262 patients with ARF in the ICU from 2014 to 2015. Our aim was to investigate the correlation between platelet count and 30-day in-hospital mortality using binary logistic regression, subgroup analyses, and smooth curve fitting.
The 30-day in-hospital mortality rate was 19.73% (4393 out of 22,262), with a median platelet count of 213 × 10/L. After adjusting for covariates, our analysis revealed an inverse association between platelet count and 30-day in-hospital mortality (OR = 0.99, 95% CI 0.99, 0.99). Subgroup analyses supported the robustness of these findings. Furthermore, a nonlinear relationship was identified between platelet count and 30-day in-hospital mortality, with the inflection point at 120 × 10/L. Below the inflection point, the effect size (OR) was 0.89 (0.87, 0.91), indicating a significant association. However, beyond this point, the relationship was not statistically significant.
This study establishes a clear negative association between platelet count and 30-day in-hospital mortality among ICU patients with ARF. Furthermore, we have identified a nonlinear relationship with saturation effects, indicating that among ICU patients with acute respiratory failure, the lowest 30-day in-hospital mortality rate occurs when the baseline platelet count is approximately 120 × 10/L.
血小板计数与急性呼吸衰竭（ARF）患者 30 天院内死亡率之间的关联证据有限。因此，本研究旨在调查 ICU 中发生急性呼吸衰竭的患者中这种关联。
我们在多个中心进行了回顾性队列研究，使用了 2014 年至 2015 年美国 eICU-CRD v2.0 数据库中涵盖 22262 名 ICU 中 ARF 患者的数据。我们旨在使用二项逻辑回归、亚组分析和平滑曲线拟合来调查血小板计数与 30 天院内死亡率之间的相关性。
30 天院内死亡率为 19.73%（22262 例中的 4393 例），血小板计数中位数为 213×10/L。在调整了协变量后，我们的分析显示血小板计数与 30 天院内死亡率之间呈负相关（OR=0.99，95%CI 0.99，0.99）。亚组分析支持这些发现的稳健性。此外，还发现血小板计数与 30 天院内死亡率之间存在非线性关系，拐点在 120×10/L。在拐点以下，效应大小（OR）为 0.89（0.87，0.91），表明存在显著关联。然而，超过这个点，关系就没有统计学意义了。
本研究确立了 ICU 中 ARF 患者血小板计数与 30 天院内死亡率之间明确的负相关关系。此外，我们还发现了一种具有饱和效应的非线性关系，表明在 ICU 中患有急性呼吸衰竭的患者中，当基线血小板计数约为 120×10/L 时，最低的 30 天院内死亡率发生。
