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Published on: May 23, 2025
Platelet-To-Lactate Ratio Predicts In-Hospital Mortality in Patients With Sepsis-Induced Coagulopathy: A
Shuai Mao1,2,3, Xuan Zhang4, Shengshu Wang1,2
1Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 100853 Beijing, China.
Summary
The platelet-to-lactate ratio (PLAC) effectively predicts in-hospital mortality in sepsis-induced coagulopathy (SIC). A PLAC threshold of 28 indicates higher mortality risk, offering a simple tool for patient stratification.
Area of Science:
- Critical Care Medicine
- Hematology
- Biomarker Discovery
Background:
- Sepsis-induced coagulopathy (SIC) presents a significant threat with high mortality rates.
- Individual markers like platelet count and lactate levels have limited prognostic value in SIC.
- The platelet-to-lactate ratio (PLAC) combines these markers, but its prognostic role in SIC requires further investigation.
Purpose of the Study:
- To investigate the association between the platelet-to-lactate ratio (PLAC) and in-hospital mortality in patients with sepsis-induced coagulopathy (SIC).
- To determine if PLAC can serve as a prognostic biomarker for mortality risk in SIC patients.
Main Methods:
- Retrospective cohort study of 1722 patients with SIC admitted to the ICU.
- Multivariate Cox regression and restricted cubic spline (RCS) analysis to assess PLAC's association with mortality and identify threshold effects.
- Comparison of PLAC's predictive performance against SOFA, SIC, and Charlson comorbidity index scores using ROC curves.
Main Results:
- In-hospital mortality was 26.2% among SIC patients; nonsurvivors exhibited significantly lower PLAC values (13.44 vs. 32.75).
- Lower PLAC tertiles were associated with significantly higher mortality risk (adjusted HRs 1.701 and 3.501).
- RCS analysis identified a threshold effect at PLAC = 28. PLAC demonstrated superior predictive performance compared to SIC and Charlson scores, comparable to the SOFA score.
Conclusions:
- The platelet-to-lactate ratio (PLAC) is independently associated with in-hospital mortality in sepsis-induced coagulopathy (SIC).
- A clinically actionable PLAC threshold of 28 can aid in risk stratification for SIC patients.
- PLAC offers a simple, integrated biomarker for assessing coagulation and perfusion status, though validation in prospective studies is recommended.