Department of Intensive care unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhe Jiang, 310000, China, No 3 East Road Qingchun.
BMC Pulm Med. 2024 Aug 17;24(1):396. doi: 10.1186/s12890-024-03204-5.
This study aimed to evaluate the role of platelet count (PLT) in the prognosis of patients with acute respiratory distress syndrome (ARDS).
The data were extracted from the Medical Information Mart for Intensive Care database (version 2.2). Patients diagnosed with ARDS according to criteria from Berlin Definition and had the platelet count (PLT) measured within the first day after intensive care unit admission were analyzed. Based on PLT, ARDS patients were divided into four groups: PLT ≤ 100 × 10/L, PLT 101-200 × 10/L, PLT 201-300 × 10/L, and PLT > 300 × 10/L. The primary outcome was 28-day mortality. Survival probabilities were analyzed using Kaplan-Meier. Furthermore, the association between PLT and mortality in ARDS patients was assessed using a univariate and multivariable Cox proportional hazards model.
Overall, the final analysis included 3,207 eligible participants with ARDS. According to the Kaplan-Meier curves for 28-day mortality of PLT, PLT ≤ 100 × 10/L was associated with a higher incidence of mortality (P = 0.001), the same trends were observed in the 60-day (P = 0.001) and 90-day mortality (P = 0.001). In the multivariate model adjusted for the potential factors, the adjusted hazard ratio at PLT 101-200 × 10/L group, PLT 201-300 × 10/L, and PLT > 300 × 10/L was 0.681 [95% confidence interval (CI): 0.576-0.805, P < 0.001], 0.733 (95% CI: 0.604-0.889, P = 0.002), and 0.787 (95% CI: 0.624-0.994, P = 0.044) compared to the reference group (PLT ≤ 100 × 10/L), respectively. Similar relationships between the PLT ≤ 100 × 10/L group and 28-day mortality were obtained in most subgroups.
PLT appeared to be an independent predictor of mortality in critically ill patients with ARDS.
本研究旨在评估血小板计数（PLT）在急性呼吸窘迫综合征（ARDS）患者预后中的作用。
从医疗信息集市重症监护数据库（版本 2.2）中提取数据。根据柏林定义诊断为 ARDS 的患者，并在入住重症监护病房后第一天内测量血小板计数（PLT），对其进行分析。根据 PLT，将 ARDS 患者分为四组：PLT≤100×10/L、PLT 101-200×10/L、PLT 201-300×10/L 和 PLT＞300×10/L。主要结局为 28 天死亡率。使用 Kaplan-Meier 分析生存概率。此外，使用单变量和多变量 Cox 比例风险模型评估 PLT 与 ARDS 患者死亡率之间的关系。
总体而言，最终分析包括 3207 名符合条件的 ARDS 患者。根据 PLT 28 天死亡率的 Kaplan-Meier 曲线，PLT≤100×10/L 与死亡率升高相关（P=0.001），60 天（P=0.001）和 90 天死亡率（P=0.001）也呈现相同趋势。在调整潜在因素的多变量模型中，PLT 101-200×10/L 组、PLT 201-300×10/L 和 PLT＞300×10/L 的调整后的危险比分别为 0.681[95%置信区间（CI）：0.576-0.805，P＜0.001]、0.733（95%CI：0.604-0.889，P=0.002）和 0.787（95%CI：0.624-0.994，P=0.044），与参考组（PLT≤100×10/L）相比。在大多数亚组中，PLT≤100×10/L 组与 28 天死亡率之间也存在类似的关系。
PLT 似乎是危重症 ARDS 患者死亡率的独立预测因子。
