Abstract
Background: There is limited evidence on the correlation between platelet counts and all-cause mortality in critically ill patients with acute respiratory failure (ARF). The aim was to evaluate whether platelet count was associated with all-cause mortality in critical patients with ARF by using the eICU Collaborative Research Database.Methods: Using a retrospective multicenter cohort dataset, data of 26961 patients with ARF in ICU between 2014 and 2015 were collected. The independent variable was log2 basal platelet count, and the dependent variables were all-cause mortality in hospital and in ICU. Covariates included demographic data, Acute Physiology and Chronic Health Evaluation (APACHE) IV score, supportive treatment, and comorbidities.Results: In fully adjusted model, log2 basal platelet count was negatively associated with all-cause mortality both in hospital [ RR:0.87, 95% CI: 0.84 - 0.91] or in ICU [RR: 0.87, 95% CI:0.83, 0.92]. By nonlinearity test, the relationship between log2 basal platelet count and all-cause mortality in hospital and in ICU were nonlinear. The inflection point we got was 6.83 and 6.86 (after inverse log2 logarithmic conversion, the platelet count are 114×109/L and 116×109/L). There was no a correlation between blood platelets and all-cause mortality in hospital on the right side of the inflection point, (RR:0.96, 95% CI: 0.88-1.03) and in ICU (RR:0.97, 95% CI: 0.91-1.04).Conclusions: For patients with ARF in ICU, platelet count was negatively associated with all-cause mortality in hospital and in ICU when platelet count is less than 114 ×109/L and 116 ×109/L respectively, but when the platelet count was higher, we failed to observe a correlation between them. The safe ranges of platelet count we detected were 78×109/L -145×109/L and 89×109/L -147×109/L respectively.
66942 Metabolomic endotype of bioenergetic dysfunction predicts mortality in critically ill patients with acute respiratory failure
