Prognostic value of platelet dynamic changes in patients with extracorporeal membrane oxygenation
10.3760/cma.j.issn.1671-0282.2022.12.007
- VernacularTitle:血小板动态变化对体外膜肺氧合患者预后的预测价值分析
- Author:
Baoquan LI
1
;
Jinsong ZHANG
;
Xufeng CHEN
;
Yong MEI
;
Jinru LV
;
Wei LI
;
Deliang HU
;
Gang ZHANG
;
Feng SUN
;
Huazhong ZHANG
;
Zhongman ZHANG
Author Information
1. 南京医科大学第一附属医院急诊科，南京 210029
- Keywords:
Platelets;
Platelet dynamic changes;
Extracorporeal membrane oxygenation;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2022;31(12):1612-1617
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of platelet dynamics on the prognosis of 28-day in patients with extracorporeal membrane oxygenation (ECMO).Methods:From January 2017 to December 2020, 60 patients from the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University received ECMO for life support. The baseline data of the patients were collected, the minimum value of platelets on day 1-7 of the machine was calculated, and the platelet change value and change rate were calculated. The patients were divided into the survival group and death group according to the 28-day survival status after ECMO was installed, and the receiver operating curve (ROC) was drawn based on the platelet change value and change rate to evaluate its predictive value for prognosis.Results:Among patients receiving VV-ECMO, the platelet change value and change rate on day 7 had the best prediction effect on the patient's 28-day outcome ( AUCΔPLT7=0.772, P=0.016; AUCΔPLT7%=0.764, P=0.020), when the platelet change value was 4×10 9/L as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99% as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99%. The sensitivity was 0.643 with a specificity of 0.846. In patients receiving VA-ECMO, the platelet change rate on day 6 predicted the best effect on the patient's 28-day outcome ( AUCΔPLT6%= 0.707, P = 0.045). When the platelet change rate was -26.19% as the critical value, the sensitivity was 0.842 and the specificity was 0.643. Conclusions:Platelet dynamic changes of platelets are correlated with the 28-day prognosis of patients receiving ECMO, and the combination of platelet change value and the critical value of change rate can better predict the poor prognosis of patients in both ECMO modes.
