Platelet count as a prognostic marker for acute respiratory distress syndrome

Abstract

Abstract Background The purpose of the present study was to evaluate the role of platelet count(PLT) in the prognosis of acute respiratory distress syndrome (ARDS) patients. Methods We extracted data from the MIMIC-IV database, patients who diagnosed with ARDS according to criteria from Berlin Definition and had the PLT taken within the first day after intensisve care unit admission were analyzed.ARDS patients were assigned to one of four categories based on platelet counts (PLT ≤ 100×10^9/L,PLT 101–200×10^9/L,PLT 201–300×10^9/L,PLT > 300×10^9/L).The primary outcome was 28-day mortaily.Survival probabilities was anayled by Kaplan-Meier.Further,the association between platelets count and mortality in ARDS patients was assessed by univariate and multivariable cox proportional hazards model. Results Overall, 3207 eligible participants with ARDS were included in the final analysis. From the Kaplan–Meier curves for 28-day mortality of PLT, PLT ≤ 100×10^9/L was associated with higher incidence of mortality(P = 0.001),the same trends were found in the 60-day(P = 0.001) and 90‐day mortality(P = 0.001). In the multivariate model adjusted for the potential factors, the adjusted hazard ratio (aHR) at PLT 101–200×10^9/L group,PLT 201–300×10^9/L,and PLT > 300×10^9/L was 0.522 [95% confidence interval (CI), 0.433–0.613,P = 0.000],0.572(95%CI,0.472–0.692,P = 0.000),and 0.681(95%CI,0.541–0.859,P = 0.000) compared with the reference group (PLT ≤ 100×10^9/L) relatively.In most subgroups,similar associations between PLT ≤ 100×10^9/L group and 28-day mortality were obtained. Conclusion Platelet count ≤ 100×10^9/L was strongly correlated with mortality in ARDS patients.These findings promoted the use of PLT as a prognostic biomarker with high predictive value for ARDS patients.