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The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing

Liangshan Wang1, Juanjuan Shao1, Chengcheng Shao1

  • 1Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Frontiers in Medicine
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PubMed
Summary

A significant drop in platelet count within the first day of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is linked to higher mortality in post-cardiotomy shock patients. Monitoring this relative platelet decrease (RelΔplatelet) can help predict outcomes.

Keywords:
decreasemortalityplatelet countpost-cardiotomy cardiogenic shockvenoarterial extracorporeal membrane oxygenation

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Area of Science:

  • Cardiovascular Medicine
  • Critical Care Medicine
  • Hematology

Background:

  • Post-cardiotomy cardiogenic shock (PCS) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) face high mortality risks.
  • The prognostic value of platelet count changes in these critically ill patients remains under-investigated.

Purpose of the Study:

  • To investigate the association between the relative decrease in platelet count (RelΔplatelet) on day 1 of VA-ECMO and in-hospital mortality in PCS patients.

Main Methods:

  • Retrospective analysis of 178 PCS patients treated with VA-ECMO from January 2016 to December 2018.
  • Multivariable logistic regression was used to assess the relationship between RelΔplatelet and in-hospital mortality.

Main Results:

  • Patients with RelΔplatelet ≥ 50% exhibited significantly higher in-hospital mortality (57% vs. 37%, p < 0.001).
  • A large RelΔplatelet (≥50%) was an independent predictor of mortality (OR 8.93, p < 0.001).
  • RelΔplatelet demonstrated superior predictive accuracy for mortality compared to absolute platelet count on day 1 (AUC 0.78 vs. 0.69).

Conclusions:

  • A substantial relative platelet count decrease within the first day of VA-ECMO initiation is independently associated with increased in-hospital mortality in PCS patients.
  • RelΔplatelet serves as a valuable early predictor of mortality in this high-risk population.