Rieß Christoph, Darkwah Oppong Marvin, Dinger Thiemo-Florin, Rodemerk Jan, Rauschenbach Laurèl, Gümüs Meltem, Frank Benedikt, Dammann Philipp, Wrede Karsten Henning, Sure Ulrich, Jabbarli Ramazan
Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, 45147, Essen, Germany.
World Neurosurg X. 2024 Mar 2;22:100302. doi: 10.1016/j.wnsx.2024.100302. eCollection 2024 Apr.
Baseline values and the change of platelet count (PLT) during disease were reported to be associated with prognosis of patients with cancer and intensive care treatment. We aimed to evaluate the association between PLT with the course and prognosis of aneurysmal subarachnoid hemorrhage (SAH).
Admission (AdmPLT) and the 14-days mean PLT (MeanPLT) values of 763 SAH patients treated between 01/2005 and 06/2016 were recorded and, for further analysis, divided into four categories: <150, 150-260, 261-400 and > 400 × 10/L. Primary endpoints were cerebral infarcts in follow-up computed tomography scans, in-hospital mortality and unfavorable outcome at 6-months follow-up defined as modified Rankin scale>3. Adverse events during SAH were assessed as secondary endpoints.
Higher PLT values were independently associated with lower risk of cerebral infarction (MeanPLT: aOR = 0.65 per-PLT-category-increase, = 0.001), in-hospital mortality (AdmPLT: aOR = 0.64, = 0.017; MeanPLT: aOR = 0.23, < 0.0001) and unfavorable outcome (AdmPLT: aOR = 0.70, = 0.031; MeanPLT: aOR = 0.35, < 0.0001). Moreover, individuals with poorer outcome were less prone to PLT increase during SAH (mean values: -+20.3 vs + 30.5 × 10/L for cerebral infarction; +9.3 vs + 32.8 × 10/L for in-hospital mortality; +14.4 vs + 31.1 × 10/L for unfavorable outcome). The following adverse events during SAH were related to AdmPLT and/or MeanPLT: non-aneurysm related secondary rebleeding, intracranial hypertension requiring conservative treatment or decompressive craniectomy, sepsis and acute kidney failure.
Low PLT at admission and their less prominent increase during SAH were strongly linked with poor outcome of SAH. Further analysis is required to clarify the background of this association and potential therapeutic implications.
据报道，疾病期间血小板计数（PLT）的基线值及变化与癌症患者和重症监护治疗患者的预后相关。我们旨在评估PLT与动脉瘤性蛛网膜下腔出血（SAH）病程及预后之间的关联。
记录了2005年1月至2016年6月期间接受治疗的763例SAH患者的入院时PLT（AdmPLT）和14天平均PLT（MeanPLT）值，并为进一步分析将其分为四类：<150、150 - 260、261 - 400和>400×10⁹/L。主要终点为随访计算机断层扫描中的脑梗死、住院死亡率以及6个月随访时改良Rankin量表>3定义的不良结局。SAH期间的不良事件作为次要终点进行评估。
较高的PLT值与较低的脑梗死风险（MeanPLT：每增加一个PLT类别，调整后比值比[aOR]=0.65，P = 0.001）、住院死亡率（AdmPLT：aOR = 0.64，P = 0.017；MeanPLT：aOR = 0.23，P < 0.0001）和不良结局（AdmPLT：aOR = 0.70，P = 0.031；MeanPLT：aOR = 0.35，P < 而不良结局者在SAH期间PLT升高的可能性较小（平均值：脑梗死为 - 20.3± 与 + 30.5×10⁹/L；住院死亡率为 + 9.3与 + 32.8×10⁹/L；不良结局为 + 14.4与 + 31.1×10⁹/L）。SAH期间的以下不良事件与AdmPLT和/或MeanPLT相关：非动脉瘤相关的继发性再出血、需要保守治疗或减压颅骨切除术的颅内高压、败血症和急性肾衰竭。结论：入院时PLT低及其在SAH期间升高不明显与SAH的不良结局密切相关。需要进一步分析以阐明这种关联的背景及潜在的治疗意义。 0.0001）独立相关。此外，结局较差的个体在SAH期间PLT升高的可能性较小（平均值：脑梗死为 - 20.3± 与 + 30.5×10⁹/L；住院死亡率为 + 9.3与 + 32.8×10⁹/L；不良结局为 + 14.4与 + 31.1×10⁹/L）。SAH期间的以下不良事件与AdmPLT和/或MeanPLT相关：非动脉瘤相关的继发性再出血、需要保守治疗或减压颅骨切除术的颅内高压、败血症和急性肾衰竭。结论：入院时PLT低及其在SAH期间升高不明显与SAH的不良结局密切相关。需要进一步分析以阐明这种关联的背景及潜在的治疗意义。
（注：原文中部分“ = ”“ < ”处可能是格式问题或有缺失内容，翻译时保留了原文形式。）
