血小板数和败血症患者28天死亡率的早期动态变化:使用动态潜伏类模型和通用添加剂混合物模型分析的回顾性队列研究
Yong Han1,2, Jie Liu1, Zhenhua Huang1,2
1Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Frontiers in medicine
|July 24, 2025
概括
血小板数的早期动态变化与败血症患者的28天死亡率有关. 监测这些血小板 (PLT) 变化可以识别高风险个体,以便更好地治疗败血症.
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
- 临床病理学 临床病理学
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染的反应失调引起的.
- 之前关于血小板计数 (PLT) 在败血症中的研究通常依赖于单个基线测量,可能缺少关键的动态信息.
- 了解动态PLT变化可能为败血症预后提供新的见解.
研究的目的:
- 调查中国血清病患者血小板数的早期动态变化与28天死亡率之间的关联.
- 解决先前研究的局限性,仅关注基线PLT水平.
主要方法:
- 对266名败血症患者进行了回顾性队列研究.
- 动态潜伏类模型来分析第一周期间的PLT计数变化.
- 考克斯比例危险回归和通用添加混合模型 (GAMM) 来评估死亡风险和轨迹差异.
主要成果:
- 与持久高的PLT计数相比,降低的 (HR: 3.710) 和持久低的PLT计数 (HR: 4.258) 与明显更高的28天死亡率有关.
- 死亡的患者的PLT数量显著降低和下降,而幸存者则呈现上升趋势.
- 在死亡率和生存率组之间观察到PLT计数轨迹的显著差异.
结论:
- 在前7天内血小板数的早期动态变化与败血症28天死亡率独立相关.
- 败血症患者的PLT数量低且下降,面临更高的死亡风险.
- 早期PLT变化的动态监测可以帮助识别高风险患者并指导个性化的败血症管理策略.
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