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在ICU患者中的血小板减少和血小板输血:国际初始队列研究 (PLOT-ICU)
Carl Thomas Anthon1, Frédéric Pène2, Anders Perner1,3,4
1Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Intensive care medicine
|October 9, 2023
概括
血小板缺血症是重症监护室 (ICU) 患者常见的疾病,影响了43%的重症患者,并与更糟糕的结果有关. 这项研究强调了低血小板计数在ICU环境中的患病率和影响.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 血小板减少 (血小板数 < 150 × 10 ^ 9 / L) 是重症监护室 (ICU) 患者经常出现的并发症.
- 它通常与较差的临床结果和增加的死亡率有关.
研究的目的:
- 介绍有关ICU患者血小板缺血发病率的当代国际数据.
- 调查在ICU住院期间发展血小板缩的危险因素.
- 分析血小板缺血和90天死亡率之间的关联.
主要方法:
- 一项前性队列研究,涉及10个国家的52个ICU的1166名成年ICU患者.
- 数据收集包括血小板计数,血小板输血使用,临床结果 (包括死亡率) 和潜在的风险因素.
- 使用后勤回归分析来评估血小板缺血和死亡率之间的关联.
主要成果:
- 总体而言,43.2%的患者患有血小板缺血症,23.4%的患者在入院时患有血小板缺血症,19.8%的患者在住院期间患有血小板缺血症.
- 与发展血小板缺血相关的因素包括没有艾滋病,非癌症免疫缺陷,肝衰竭,男性性,败血性休克和出血.
- 血小板缺血与更高的出血率,死亡和减少没有生命支持或出院的生存日数有关. 在ICU入院时的血小板缺血预测了90天的死亡率 (aOR 1.7).
结论:
- 血小板缺血在重症患者中很普遍,发生在43%的患者中,并与不良结果相关,包括增加死亡率.
- 血小板输血给了22.6%的血小板缺血患者,大多数是预防性的.
- 这些发现强调了监测和管理ICU中血小板缺血的重要性.
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