Objectives: Although platelets have been linked to inflammatory development in sepsis, knowledge on their role as an indicator in sepsis treatment is scarce. Here, we investigated the association between time-dependent changes in platelet counts with mortality rates to reveal the role of platelets in sepsis therapy.
Design: A retrospective cohort study.
Setting: We screened the Medical Information Mart for Intensive Care (MIMIC-IV), a public database comprising data from critical care subjects at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, Massachusetts, USA.
Participants: A total of 7981 patients, who were admitted to the BIDMC between 2008 and 2019, were analysed based on Sepsis-3 criteria from MIMIC-IV.
Primary and secondary outcome measures: Primary and secondary outcomes included 30-day mortality after admission and length of intensive care unit (ICU) stay and hospitalisation, respectively.
Results: Patients with ≤10% reduction in proportion of platelet counts were associated with significantly lower 30-day mortality (14.1% vs 23.5%, p<0.001, Kaplan-Meier analysis, p<0.0001). Multivariable analysis revealed that decreased platelet-count percentage ≤10% on day 4 after ICU admission was associated with lower probability of 30-day non-survival (OR=0.73, 95% CI 0.64 to 0.82, p<0.001). Patients in the ≤10% group had significantly shorter ICU stays than those in the >10% group (6.8 vs 7.5, p<0.001). Restricted cubic spline curves revealed that mortality rates decreased with increase in proportion of platelet counts.
Conclusions: A ≤10% decrease in platelet-count percentage among sepsis patients after treatments is independently associated with decreased 30-day mortality, suggesting that changes in proportion of platelet counts after treatments could be an indicator for assessing the therapeutic effects of sepsis.
Keywords: adult intensive & critical care; infectious diseases; intensive & critical care.
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