Τίτλος:
Thrombocytopenia in critically ill patients with severe sepsis/septic shock: Prognostic value and association with a distinct serum cytokine profile
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: The purpose of the study is to evaluate the incidence, association with serum cytokine profile, and prognostic value of thrombocytopenia, in critically ill patients with severe sepsis/septic shock. Methods: A cohort of 105 consecutive patients admitted in intensive care unit was included in our analysis. Serum levels of intercellular adhesion molecule, vascular cell adhesion molecule, interferon γ, interleukin 8, and soluble form of the urokinase-type plasminogen activator receptor (suPAR) were measured. Results: Thrombocytopenia was observed in 53% of patients at the time of admission. Platelet counts showed a statistically significant negative correlation with serum levels of intercellular adhesion molecule, suPAR, and interleukin 8 (P <.0001). In multivariate analysis, high Acute Physiological and Chronic Health Evaluation II score, high serum suPAR, and low platelet counts were associated with increased mortality, and receiver operating characteristic curve analysis was used to determine the best cutoff value for mortality prediction. Each variable with a value above or below the predefined cutoff levels were given 1 point. Patients were categorized in risk groups based on total point score. High-risk (2-3), intermediate-risk (1), and low-risk (0 points) groups consisted of 43%, 22%, and 35% and 28-day mortality was observed in 69%, 26%, and 3% of the patients in each group, respectively. Conclusion: Thrombocytopenia is associated with poor prognosis and a distinct serum cytokine profile. © 2015 Elsevier Inc.
Συγγραφείς:
Tsirigotis, P.
Chondropoulos, S.
Frantzeskaki, F.
Stamouli, M.
Gkirkas, K.
Bartzeliotou, A.
Papanikolaou, N.
Atta, M.
Papassotiriou, I.
Dimitriadis, G.
Dimopoulou, I.
Περιοδικό:
Journal of Critical Care
Λέξεις-κλειδιά:
cell adhesion molecule; cytokine; gamma interferon; intercellular adhesion molecule; interleukin 8; unclassified drug; urokinase receptor; vascular cell adhesion molecule; biological marker; cytokine; IL8 protein, human; interleukin 8; urokinase receptor, adult; aged; APACHE; Article; critically ill patient; diagnostic test accuracy study; female; high risk patient; human; intermediate risk patient; low risk patient; major clinical study; male; mortality; observational study; prediction; prognosis; prospective study; protein blood level; receiver operating characteristic; risk assessment; sensitivity and specificity; sepsis; septic shock; thrombocyte count; thrombocytopenia; very elderly; blood; complication; critical illness; epidemiology; Greece; hospital mortality; incidence; intensive care; middle aged; mortality; prognosis; sepsis; thrombocytopenia, Adult; Aged; Biomarkers; Critical Care; Critical Illness; Cytokines; Female; Greece; Hospital Mortality; Humans; Incidence; Interleukin-8; Male; Middle Aged; Prognosis; Prospective Studies; Receptors, Urokinase Plasminogen Activator; ROC Curve; Sepsis; Thrombocytopenia
DOI:
10.1016/j.jcrc.2015.11.010
