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Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study
BACKGROUND: Early detection of the Acute Respiratory Distress Syndrome (ARDS) has the potential to improvethe prognosis of critically ill patients admitted to the intensive care unit (ICU). However, no reliable biomarkers are currently available for accurate early detection of ARDS in patients with...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986053/ https://www.ncbi.nlm.nih.gov/pubmed/24732309 http://dx.doi.org/10.1371/journal.pone.0094124 |
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author | Wang, Tiehua Liu, Zhuang Wang, Zhaoxi Duan, Meili Li, Gang Wang, Shupeng Li, Wenxiong Zhu, Zhaozhong Wei, Yongyue Christiani, David C. Li, Ang Zhu, Xi |
author_facet | Wang, Tiehua Liu, Zhuang Wang, Zhaoxi Duan, Meili Li, Gang Wang, Shupeng Li, Wenxiong Zhu, Zhaozhong Wei, Yongyue Christiani, David C. Li, Ang Zhu, Xi |
author_sort | Wang, Tiehua |
collection | PubMed |
description | BACKGROUND: Early detection of the Acute Respiratory Distress Syndrome (ARDS) has the potential to improvethe prognosis of critically ill patients admitted to the intensive care unit (ICU). However, no reliable biomarkers are currently available for accurate early detection of ARDS in patients with predisposing conditions. OBJECTIVES: This study examined risk factors and biomarkers for ARDS development and mortality in two prospective cohort studies. METHODS: We examined clinical risk factors for ARDS in a cohort of 178 patients in Beijing, China who were admitted to the ICU and were at high risk for ARDS. Identified biomarkers were then replicated in a second cohort of1,878 patients in Boston, USA. RESULTS: Of 178 patients recruited from participating hospitals in Beijing, 75 developed ARDS. After multivariate adjustment, sepsis (odds ratio [OR]:5.58, 95% CI: 1.70–18.3), pulmonary injury (OR: 3.22; 95% CI: 1.60–6.47), and thrombocytopenia, defined as platelet count <80×10(3)/µL, (OR: 2.67; 95% CI: 1.27–5.62)were significantly associated with increased risk of developing ARDS. Thrombocytopenia was also associated with increased mortality in patients who developed ARDS (adjusted hazard ratio [AHR]: 1.38, 95% CI: 1.07–1.57) but not in those who did not develop ARDS(AHR: 1.25, 95% CI: 0.96–1.62). The presence of both thrombocytopenia and ARDS substantially increased 60-daymortality. Sensitivity analyses showed that a platelet count of <100×10(3)/µLin combination with ARDS provide the highest prognostic value for mortality. These associations were replicated in the cohort of US patients. CONCLUSIONS: This study of ICU patients in both China and US showed that thrombocytopenia is associated with an increased risk of ARDS and platelet count in combination with ARDS had a high predictive value for patient mortality. |
format | Online Article Text |
id | pubmed-3986053 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-39860532014-04-15 Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study Wang, Tiehua Liu, Zhuang Wang, Zhaoxi Duan, Meili Li, Gang Wang, Shupeng Li, Wenxiong Zhu, Zhaozhong Wei, Yongyue Christiani, David C. Li, Ang Zhu, Xi PLoS One Research Article BACKGROUND: Early detection of the Acute Respiratory Distress Syndrome (ARDS) has the potential to improvethe prognosis of critically ill patients admitted to the intensive care unit (ICU). However, no reliable biomarkers are currently available for accurate early detection of ARDS in patients with predisposing conditions. OBJECTIVES: This study examined risk factors and biomarkers for ARDS development and mortality in two prospective cohort studies. METHODS: We examined clinical risk factors for ARDS in a cohort of 178 patients in Beijing, China who were admitted to the ICU and were at high risk for ARDS. Identified biomarkers were then replicated in a second cohort of1,878 patients in Boston, USA. RESULTS: Of 178 patients recruited from participating hospitals in Beijing, 75 developed ARDS. After multivariate adjustment, sepsis (odds ratio [OR]:5.58, 95% CI: 1.70–18.3), pulmonary injury (OR: 3.22; 95% CI: 1.60–6.47), and thrombocytopenia, defined as platelet count <80×10(3)/µL, (OR: 2.67; 95% CI: 1.27–5.62)were significantly associated with increased risk of developing ARDS. Thrombocytopenia was also associated with increased mortality in patients who developed ARDS (adjusted hazard ratio [AHR]: 1.38, 95% CI: 1.07–1.57) but not in those who did not develop ARDS(AHR: 1.25, 95% CI: 0.96–1.62). The presence of both thrombocytopenia and ARDS substantially increased 60-daymortality. Sensitivity analyses showed that a platelet count of <100×10(3)/µLin combination with ARDS provide the highest prognostic value for mortality. These associations were replicated in the cohort of US patients. CONCLUSIONS: This study of ICU patients in both China and US showed that thrombocytopenia is associated with an increased risk of ARDS and platelet count in combination with ARDS had a high predictive value for patient mortality. Public Library of Science 2014-04-14 /pmc/articles/PMC3986053/ /pubmed/24732309 http://dx.doi.org/10.1371/journal.pone.0094124 Text en © 2014 Wang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Wang, Tiehua Liu, Zhuang Wang, Zhaoxi Duan, Meili Li, Gang Wang, Shupeng Li, Wenxiong Zhu, Zhaozhong Wei, Yongyue Christiani, David C. Li, Ang Zhu, Xi Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title | Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title_full | Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title_fullStr | Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title_full_unstemmed | Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title_short | Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study |
title_sort | thrombocytopenia is associated with acute respiratory distress syndrome mortality: an international study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986053/ https://www.ncbi.nlm.nih.gov/pubmed/24732309 http://dx.doi.org/10.1371/journal.pone.0094124 |
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