| Objective: Platelet count(PLT),mean platelet volume(MPV)and MPV / PLT can predict the clinical prognosis of many diseases.However,the predictive value of PLT,MPV and MPV / PLT for the prognosis of urosepsis has not been reported.The purpose of this study was to investigate the correlation between PLT,MPV,MPV / PLT and in-hospital mortality in patients with urosepsis,and to analyze the predictive value of these indicators for 28 day mortality risk in patients with urosepsis.Methods: Patients with urosepsis admitted to the emergency department of Lu 'an Hospital affiliated to Anhui Medical Universityfrom January 2017 to April 2019 were selected.According to The Chinese Expert Consensus on the Diagnosis and Treatment of Urinary Tract Infection(2015 Edition),and in line with The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3)? Patients who had recently taken aspirin,dipyridamole,heparin and other drugs,patients with blood diseases,chronic underlying liver and kidney diseases,patients who had recently received platelet transfusion,pregnant women,and patients younger than 18 years of age were excluded.A total of 86 patients with urosepsis were included in the study.The clinical indexes on the day of admission,PLT,MPV,MPV / PLT levels of all patients at admission(0 h)and 24h(24h)were recorded,and the acute physiology and chronic health score II(APACHE ?),quick sequential organ failure score(qSOFA)and SOFA score were recorded within 24h after admission.According to the survival status after 28 days of treatment,they were divided into survival group(64 cases)and death group(22 cases).At the same time,30 healthy people in the physical examination center of our hospital were selected as the control group.Spss22.0 software was used to analyze the parameters of the two groups of patients.The utilization rate of the counting data(%)was expressed and compared with the Maple 2 test.The measurement data were expressed as(± s)and compared by t-test.measurement data that did not conform to normal distribution were expressed as median,25% and 75% percentile,non-parametric test was used,and Wilcoxon test was used for comparison between the two groups.The parameters of PLT,MPV and MPV / PLT were analyzed by ROC curve and the best cut-off value was obtained.Multivariate logistic regression analysis was used to determine the independent risk factors of hospital death in patients with urosepsis,and the difference was statistically significant(P < 0.05).Results: The levels of control group PLT > survival group PLT-0h > death group PLT-0h.Control group MPV,MPV/PLT < survival group MPV-0h,MPV/ PLT-0h < death group MPV-0h,MPV/plt-0h.Death group systolic blood pressure(SBP)was lower than survival group(P< 0.05).The blood lactate,APACHE ? score,qSOFA score,SOFA score,MPV / plt-0h,mpv-24h,MPV / plt-24h in death group were significantly higher than those in survival group(P < 0.05).MPV-24h and APACHE ? score have high predictive value for the risk of death.The area under the curve(AUC)of MPV-24h was0.888.When the optimal cutoff value was 12.1,the sensitivity was 72.7%,and the specificity was 98.4%.The AUC of APACHE ? score in predicting the risk of death was 0.914.When the optimal cutoff value was 18,the sensitivity was 81.8%,and the specificity was 82.8%.MPV-24h and APACHE ? score were independent risk factors of28-day mortality in patients with urosepsis.(P< 0.05)Conclusion: PLT,MPV and MPV / PLT can evaluate the prognosis of patients with urosepsis,and MPV-24h has a good predictive value for 28-day mortality risk of patients with urosepsis.As it is an economical and convenient way to detect PLT,MPV and MPV/PLT in patients with urosepsis,the potential predictive value of PLT,MPV,MPV/PLT changes on the prognosis of patients with urosepsis should be integrated into the comprehensive management of patients with urinary sepsis,and further research is still needed to clarify its potential mechanism. |
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