再生障碍性贫血患者血小板组轨迹建模:基于MIMIC数据库的研究

IF 2 4区 医学 Q3 HEMATOLOGY
Lang Peng, Lixin Zou, Xiaoliu Liu
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引用次数: 0

摘要

背景:血小板是支持凝血和止血的主要成分。然而,对于住院期间血小板计数的变化如何影响再生障碍性贫血(AA)患者的预后,还没有足够的研究。目的:本研究拟采用基于组的轨迹模型(GBTM)评估AA患者血小板水平变化与疾病风险之间的关系。方法:采用GBTM对AA患者血小板水平变化进行分组。采用Cox回归模型评价血小板水平与患者30天生存状态的关系。采用Kaplan-Meier (K-M)生存曲线分析评估血小板输注对不同轨迹组患者生存的影响。结果:GBTM识别出3种轨迹类型:1类、2类和3类。即使在控制了混杂变量后,Cox风险估计显示AA患者在1级存活的机会更高(OR 1, p)。结论:住院期间血小板轨迹增加的AA患者具有更高的30天生存率;因此,血小板计数低的患者可能不适合血小板输注治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Group-Based Trajectory Modeling of Platelet in Patients with Aplastic Anemia: A Study Based on the MIMIC Database.

Background: Platelets are the main components supporting coagulation and hemostasis. Nevertheless, no sufficient research has been done on how variations in platelet counts during hospital stays affect aplastic anemia (AA) patients' prognoses.

Objective: This study proposes to evaluate the association between alterations in platelet levels and illness risk in patients with AA using group-based trajectory modeling (GBTM).

Methods: GBTM was used to group AA patients based on changes in platelet levels. Cox regression models were used to evaluate the relationship between platelet levels and patients' 30-day survival status. Kaplan-Meier (K-M) survival curve analysis was used to assess the impact of platelet transfusion on survival among different trajectory groups of patients.

Results: Three trajectory patterns were recognized by GBTM: Class 1, Class 2, and Class 3. Even after controlling for confounding variables, the Cox risk estimates showed that AA patients had a higher chance of surviving in Class 1 (OR>1, P<0.05). Class 2 patients had the greatest survival, according to K-M (Log-rank P<0.001). According to landmark research, Class 1 patients' survival was not improved by platelet transfusion.

Conclusion: Patients with AA who had increasing platelet trajectories during their hospital stay had a higher 30-day survival rate; hence, patients with low platelet counts might not be good candidates for platelet transfusion treatment.

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来源期刊
CiteScore
4.20
自引率
6.20%
发文量
113
审稿时长
12 weeks
期刊介绍: Reciprocal interdependence between infectious and hematologic diseases (malignant and non-malignant) is well known. This relationship is particularly evident in Mediterranean countries. Parasitosis as Malaria, Leishmaniosis, B Hookworms, Teniasis, very common in the southeast Mediterranean area, infect about a billion people and manifest prevalently with anemia so that they are usually diagnosed mostly by experienced hematologist on blood or bone marrow smear. On the other hand, infections are also a significant problem in patients affected by hematological malignancies. The blood is the primary vector of HIV infection, which otherwise manifest with symptoms related to a reduction in T lymphocytes. In turn, infections can favor the insurgency of hematological malignancies. The causative relationship between Epstein-Barr virus infection, Helicobacter pylori, hepatitis C virus, HIV and lymphoproliferative diseases is well known.
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