脓毒症诱发凝血功能障碍患者中脓毒症相关血小板减少症的风险因素。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-01-01 DOI:10.1177/10760296241283166
Jia-Jia Cheng, Rong Liufu, Jian Zhuang, Miao-Yun Chen
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引用次数: 0

摘要

该研究旨在评估凝血功能障碍患者中脓毒症相关血小板减少症(SAT)的预后和风险因素,并提供不良结局与潜在风险之间关系的证据。研究纳入了2014年1月至2022年12月期间的脓毒症相关凝血病患者。主要结果是脓毒症相关血小板减少症(血小板计数低于100 *109/L),该结果通过人口统计学特征和合并症调整后的逻辑回归模型进行评估。在SAT组患者中,54%的患者发展为重度SAT,而其中16%的患者从血小板减少中恢复过来。与非 SAT 组相比,SAT 组的院内死亡率明显更高(SAT 组 31% 对非 SAT 组 23.9%,P = 0.029)。即使调整了年龄、性别、Charlson 合并症、白细胞和序贯器官衰竭评估评分,死亡率的差异依然存在(比值比 0.72,[95% 置信区间 0.52-0.92])。相关性分析表明,凝血酶原时间(r = 0.08,p = 0.50)、国际标准化比值(r = 0.08,p = 0.42)、凝血酶原活动度(r = -0.06,p > 0.999)、D-二聚体(r = -0.02,p > 0.999)和炎症参数(如 C 反应蛋白)(r = -0.11,p = 0.37)与血小板计数无明显相关性。根据亚组分析,并发 SAT 的肺部感染患者死亡率略高(OR 0.66,[95% CI,0.46 至 0.94])。脓毒症相关凝血病显示了危重病人的一个亚组,与无血小板减少症的病人相比,有血小板减少症的病人院内死亡风险更高。
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Risk Factors of Sepsis-Associated Thrombocytopenia among Patients with Sepsis Induced Coagulopathy.

The study aims to evaluate the prognosis and risk factors of sepsis-associated thrombocytopenia (SAT) among patients with coagulopathy, and to provide evidence of the relationship between adverse outcomes and potential risks. Patients with sepsis-associated coagulopathy were included in the study from January 2014 to December 2022. The primary outcome was sepsis-associated thrombocytopenia (platelet count less than 100 *109/L), which was evaluated by logistic regression models adjusted for demographic characteristics and comorbidities. Among patients in the SAT group, 54% developed severe SAT, while 16% of these patients recovered from thrombocytopenia. The in-hospital mortality rate was significantly higher in the SAT group compared to the non-SAT group (31% in SAT group vs 23.9% in non-SAT group, p = 0.029). Even after adjusting for age, gender, Charlson comorbidity, white blood cell, and Sequential Organ Failure Assessment score, the differences in mortality rate persisted (Odds Ratio 0.72, [95% Confidence Interval 0.52-0.92]). Correlation analyses revealed that prothrombin time (r = 0.08, p = 0.50), international normalized ratio (r = 0.08, p = 0.42), prothrombin activity (r = -0.06, p > 0.999), D-dimer (r = -0.02, p > 0.999), and inflammatory parameters such as C-reactive protein (r = -0.11, p = 0.37) were not significantly correlated with platelet counts. According to subgroup analyses, patients with lung infection complicated by SAT had slightly higher mortality (OR 0.66, [95% CI, 0.46 to 0.94]). Sepsis-associated coagulopathy indicates a subset of critical ill patients, with those experiencing thrombocytopenia at greater risk for in-hospital death compared to those without it.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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