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血小板计数与新生儿急性肾损伤的关系:使用医疗信息集市重症监护 III 数据库的队列研究。

Association between platelet count and neonatal acute kidney injury: a cohort study using the medical information mart for intensive care III database.

机构信息

The First College of Clinical Medical Science, China Three Gorges University, Yichang, P.R. China.

Department of Pediatrics, Yichang Central People's Hospital, Yichang, P.R. China.

出版信息

J Matern Fetal Neonatal Med. 2024 Dec;37(1):2379910. doi: 10.1080/14767058.2024.2379910. Epub 2024 Jul 23.

Abstract

OBJECTIVE

A decrease in platelet count has been reported to be associated with several neonatal inflammatory diseases, including sepsis and necrotizing enterocolitis; while its association with neonatal acute kidney injury (AKI) has not been reported. This study aims to explore the association between platelet count and neonatal AKI.

METHODS

This was a retrospective cohort study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Data were extracted based on baseline characteristics, comorbidities, vital signs, laboratory parameters, and intervention measures. Logistic regression analysis was used to assess the association between platelet count and AKI, and results were shown as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS

A total of 1,576 neonates were finally included in the analysis. After adjusting birth weight, sepsis, patent ductus arteriosus, hematocrit, percentage of neutrophils, and vasopressor use, we found that platelet count in the lowest quartile (Q1) was significantly associated with the higher odds of AKI than platelet count in the highest quartile (Q4) (OR = 1.70, 95% CI: 1.01-2.87).

CONCLUSIONS

Low platelet count was associated with the high odds of AKI in the neonatal intensive care unit (NICU), indicating that platelet count might be a biomarker for neonatal AKI. Large-scale multicenter studies should be performed to verify the results.

摘要

目的

血小板计数降低与多种新生儿炎症性疾病相关,包括败血症和坏死性小肠结肠炎;而其与新生儿急性肾损伤(AKI)的关系尚未报道。本研究旨在探讨血小板计数与新生儿 AKI 的关系。

方法

这是一项基于医疗信息监护 III 数据库(MIMIC-III)的回顾性队列研究。根据基线特征、合并症、生命体征、实验室参数和干预措施提取数据。使用逻辑回归分析评估血小板计数与 AKI 的关系,结果表示为比值比(OR)及其 95%置信区间(CI)。

结果

最终共纳入 1576 例新生儿进行分析。在调整出生体重、败血症、动脉导管未闭、红细胞压积、中性粒细胞百分比和血管加压素使用后,我们发现血小板计数最低四分位(Q1)与 AKI 发生的更高几率显著相关,高于血小板计数最高四分位(Q4)(OR=1.70,95%CI:1.01-2.87)。

结论

血小板计数低与新生儿重症监护病房(NICU)中 AKI 的高几率相关,表明血小板计数可能是新生儿 AKI 的生物标志物。应进行大规模多中心研究来验证结果。

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