血小板相关参数联合肺炎严重指数评分对重症肺炎患者病死率的预测作用

doi:doi:10.3969/j.issn.1002-1949.08.006

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (8): 739-743 DOI: doi:10.3969/j.issn.1002-1949.08.006

Analysis of the mortality prediction role of platelet associated parameter test combined with PSI score in patients with severe pneumonia

Feng Kai-jun, Zhang Hong

Department of Emergency, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, China

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Abstract Objective To explore the mortality prediction role of platelet associated parameter test combined with pneumonia severity index (PSI) score in patients with severe pneumonia. Methods The clinical data of 124 patients with severe pneumonia admitted to our hospital from February 2015 to May 2018 were retrospectively reviewed and recorded as severe pneumonia group. In addition, the clinical data of 132 cases of non-severe pneumonia in the same period were reviewed according to the principle of pairing and recorded as non-severe pneumonia group. Platelet related parameters were detected in the two groups, including platelet count (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW), and the differences were compared between the two groups. The PSI scores of the severe pneumonia group were evaluated. The platelet related parameters and PSI scores of 28-day live and dead patients were compared. Receiver operating characteristic (ROC) was drawn to assess the predictive effect of subcurve area (AUC) on mortality in patients with severe pneumonia. Results The PLT, PDW, MPV and PLCR in severe pneumonia group were (289.68±35.29)×109/L, (8.08±1.19) fL, (5.96±1.28) fL, (14.26±3.17)% respectively, which were (216.42±33.55)×109/L, (12.28±1.71) fL, (8.58±1.46) fL, (17.74±3.19)% in the non-severe pneumonia group. PLT in severe pneumonia group was higher than that in non-severe pneumonia group ( P < 0.05), while PDW, MPV and P-LCR in severe pneumonia group were lower than those in non-severe pneumonia group ( P < 0.05). The PLT, PDW, MPV, P-LCR and PSI score in the death patients within 28 days were (352.45±34.29)×109/L, (5.11± 1.43 ) fL, (4.03±1.16) fL, (9.36±2.58)%, (139.32±6.19) scores respectively, which were (269.65±35.26)×10 9/L, (9.03±1.18) fL, (6.58±1.25) fL, (15.82±3.14)%, (126.21±5.10) scores in the survivors. In severe pneumonia group, the scores of PLT and PSI were higher in death patients within 28 days than those in survivors ( P < 0.05), while the scores of PDW, MPV and P-LCR were lower in survivors ( P < 0.05). The best cut-off points of PDW, MPV, PSI, PLT and P-LCR for predicting death within 28 days of severe pneumonia were 6.25 fL, 5.00 fL, 135.50, 340.00×109/L and 11.00%, respectively. AUC were 0.811, 0.802, 0.765, 0.717 and 0.639, respectively. The sensitivity, specificity and AUC of platelet-related parameters combined with PSI score were 96.67%, 98.94% and 0.939, respectively. Conclusion PLT, PDW, MPV and P-LCR are significantly abnormal in patients with severe pneumonia, and platelet related parameter detection combined with PSI score is more effective in predicting the 28-day mortality.

Key words： Platelet count (PLT) Mean platelet volume (MPV) Platelet large cell ratio (P-LCR) Platelet distribution width (PDW) Pneumonia severity index (PSI) Severe pneumonia

Corresponding Authors: Zhang Hong, E-mail: Zhanghong20070703@163.com

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Feng Kai-jun,Zhang Hong. Analysis of the mortality prediction role of platelet associated parameter test combined with PSI score in patients with severe pneumonia[J]. Chinese Journal of Critical Care Medicine, 2019, 39(8): 739-743.

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http://www.cnemergency.org.cn/EN/doi:10.3969/j.issn.1002-1949.08.006 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I8/739

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