Prognostic Value Of Platelet Parameters In Early Sepsis

Objective:Due to the complex pathophysiological process and the lack of effective treatment,the expected mortality of sepsis is high.Early recognition of sepsis and timely treatment can improve the prognosis of patients and reduce mortality to some extent.The purpose of this study was to investigate the clinical value of early identification and diagnosis of sepsis with platelet parameters.Methods: Retrospective study between January 2017 and September 2019 at shengjing hospital affiliated to China medical university,259 cases of patients with sepsis in the ICU,collect patients in ICU of 1 d,2 d,3 d the platelet parameters of platelet count(PLT),average blood platelet volume(MPV),platelet distribution width(PDW),average platelet volume/platelet count(MPR)],averaged.Multi-factor variance analysis factors that affect the platelet parameters,and according to the influencing factors of the patients group,according to the prognosis of patients with sepsis and the severity of the disease were divided into survival group and death group,sepsis and septic shock group,analysis and comparison between groups of platelet parameters,the differences between the APACHE II score,lactic acid,using ROC curve comparison platelet parameters determine the advantages and disadvantages of disease severity and prognosis.SPSS 20.0 statistical software was used for statistical processing.Multivariate analysis of variables that may affect platelets;The data of normal distribution or approximate normal distribution were expressed as mean± standard deviation(x±s).The measurement data of non-normal distribution were represented by median,and U test was used for comparison between groups.The enumeration data is expressed as a percentage and the chi-square test is used to calculate the degree of difference in the constituent ratios of two or more samples.The binary Logistic regression model was constructed with the original data of platelet parameters as independent variables,and the ROC curve of the test was drawn based on the P value of the regression model.The ROC curve was used to compare the advantages and disadvantages of different parameters of platelet in predicting the prognosis of sepsis.If P <0.05,thedifference was statistically significant.Result:(1)the PLT and PCT of the patients in the death group were lower than those in the survival group,and the MPV and MPR were higher than those in the survival group,which were positively correlated with the APACHEII score and SOFA score,and the difference was statistically significant(P < 0.05).Area under ROC curve: anticoagulation group :MPR=0.711;PLT = 0.681 PCT = 0.658,MPV = 0.620;No anticoagulation group: MPR=0.741;PLT=0.712,PCT=0.675,MPV=0.666.(2)in the septic shock group,PLT and PCT were lower than those in the sepsis group,and MPV,PDW and MPR were higher than those in the sepsis group,which were positively correlated with APACHEII score and mortality,and the difference was statistically significant(P < 0.05).Area under ROC curve: in the anticoagulation group,MPR =0.745,PLT=0.720,PCT=0.693,PDW=0.629,MPV=0.636.No anticoagulation group: MPR=0.745;PLT=0.736,PCT=0.734,MPV=0.629;PDW = 0.680.Conclusion:1.Platelet parameters(PLT,MPV,PCT,MPR)play an early warning role in the outcome and outcome of sepsis,and to a certain extent reflect the severity of the disease;PDW plays a guiding role in assisting diagnosis of disease severity.2.MPR is more valuable than any parameter of platelets in predicting the prognosis of early sepsis and is expected to become a sensitive new indicator for early prediction of sepsis.