Platelet Count During Course of Cardiogenic Shock

Area of Science:

• Cardiology
• Hematology
• Critical Care Medicine

Background:

• Cardiogenic shock (CS) is a severe condition with high mortality.
• The prognostic value of platelet count in CS patients remains underexplored.
• Limited data exists on the impact of dynamic changes in platelet count during intensive care unit (ICU) stay.

Purpose of the Study:

• To investigate the prognostic significance of baseline platelet count in CS patients.
• To assess the impact of platelet count decline during ICU hospitalization on 30-day all-cause mortality.
• To determine if dynamic platelet changes offer predictive value beyond baseline measurements.

Main Methods:

• Retrospective analysis of 249 consecutive CS patients from 2019-2021.
• Evaluation of baseline platelet count for association with 30-day mortality.
• Assessment of platelet count decrease (≥25% from day 1 to day 3) and its correlation with 30-day mortality.
• Multivariable adjustment to control for confounding factors.

Main Results:

• No significant association was found between baseline platelet count and 30-day all-cause mortality (p=0.579).
• A platelet count decrease of ≥25% from day 1 to day 3 in the ICU was significantly associated with increased 30-day all-cause mortality (HR=1.585, p=0.052).
• This association remained significant after multivariable adjustment (HR=1.951, p=0.019), indicating platelet decline is a robust predictor.

Conclusions:

• Baseline platelet count is not a reliable predictor of 30-day mortality in CS patients.
• Platelet count decrease during ICU hospitalization is a significant independent predictor of increased 30-day all-cause mortality in CS.
• Monitoring dynamic changes in platelet count during ICU stay may improve risk stratification and patient management in cardiogenic shock.