重症感染性心内膜炎患者血小板计数与28天死亡率的非线性关系:来自MIMIC IV数据库的回顾性队列研究

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1458238
Yingxiu Huang, Ting Ao, Peng Zhen, Ming Hu
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引用次数: 0

摘要

背景:重症感染性心内膜炎(IE)患者血小板计数与28天死亡率之间的关系目前尚不清楚。目的:探讨血小板计数对感染性心内膜炎危重患者28天死亡率的影响。方法:对450名确诊为感染性心内膜炎并入住重症监护病房(ICU)的患者进行回顾性队列研究。收集所有参与者的生命体征、实验室参数和合并症,分析血小板计数与28天死亡率之间的关系。为了评估血小板计数与28天死亡率之间的独立关联,我们采用多变量cox风险回归分析和平滑曲线拟合。进一步的分析使用两分段线性回归模型来检验血小板计数和住院死亡率之间的非线性关联。结果:共纳入450例感染性心内膜炎危重患者。平均年龄57.4岁,男性占64.2%。总的28天死亡率为20%。血小板计数与28天死亡率呈非线性关系。发现了两个不同的斜率,血小板计数与IE患者28天死亡率之间的相关性在拐点(约141 K/µl)以下和以上显著不同。在拐点左侧,风险比为0.990(风险比为0.990,95%可信区间为0.982 ~ 0.997,p = 0.006)。然而,在拐点右侧,风险比略有增加,达到1.0004 (HR: 1.0004, 95% CI: 0.997-1.004, p = 0.825)。值得注意的是,该关联在拐点右侧缺乏统计学意义。结论:重症感染性心内膜炎患者血小板计数与28天死亡率呈非线性相关。与最低28天死亡风险相关的最佳血小板计数高于141 k/µl。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Non-linear relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis: a retrospective cohort study from MIMIC IV database.

Background: The relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis (IE) is currently not well established.

Objective: This study aims to investigate the impact of platelet count on 28-day mortality in critically ill patients with infective endocarditis.

Methods: A retrospective cohort study was conducted involving 450 participants diagnosed with infective endocarditis and admitted to intensive care units (ICU). Vital signs, laboratory parameters and comorbidity were collected for all participants to analyze the association between platelet count and 28-day mortality. In order to assess the independent association between platelet count and 28-day mortality, we employed multivariable cox hazard regression analyses and smooth curve fitting. A further analysis was conducted using a two-piecewise linear regression model to examine the nonlinear association between platelet count and in-hospital mortality.

Results: A total of 450 critically ill patients with infective endocarditis were included in the study. The mean age was 57.4 years, and 64.2% were male. The overall 28-day mortality rate was 20%. A non-linear relationship was observed between platelet count and 28-day mortality. Two different slopes were identified, with correlations between platelet count and 28-day mortality in patients with IE differing significantly below and above the inflection point, which was approximately 141 K/µl. On the left side of the inflection point, the hazard ratio was 0.990 (hazard ratio: 0.990, 95% confidence interval: 0.982-0.997, p = 0.006). However, on the right side of the inflection point, the hazard ratio increased marginally to 1.0004 (HR: 1.0004, 95% CI: 0.997-1.004, p = 0.825). Notably, the association lacked statistical significance on the right side of the inflection point.

Conclusion: A nonlinear association between platelet count and 28-day mortality was observed in critically ill patients with infective endocarditis. The optimal platelet count associated with the lowest risk of 28-day mortality was above 141 k/µl.

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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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