Is Thrombocytopenia an In-Hospital Mortality Risk Factor among Patients with Acute Ischemic Stroke? A Propensity Score-Matched Analysis from the MIMIC-IV Database

Wang, Yanru; Yang, Li‐Yu; Lee, Chien-Hsing; Chang, Shu‐Hao; Chen, Po-Huang; Jhou, Hong-Jie

doi:10.3390/jcm12020580

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…In numerous diseases, SIRI has emerged as an independent prognostic indicator, including acute ischemic stroke, heart failure, traumatic brain injury, breast cancer, and acute pancreatitis (18)(19)(20)(21)(22). It's a composite index covering a broader scope than the two composite inflammatory indices, namely the monocyte-tolymphocyte ratio (MLR) and the neutrophil-to-lymphocyte ratio (NLR).…”

Section: Discussionmentioning

confidence: 99%

A nonlinear relationship between systemic inflammation response index and short-term mortality in patients with acute myocardial infarction: a retrospective study from MIMIC-IV

Wang¹,

Chen²

2023

Front. Cardiovasc. Med.

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BackgroundThis investigation aimed to evaluate the efficacy of the Systemic Inflammatory Response Index (SIRI) in prognosticating short-term all-cause mortality among patients diagnosed with acute myocardial infarction (AMI) in the intensive care unit (ICU).Methods and ResultsClinical data were obtained from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. A total of 4,291 patients were included in the cohort. Results from multivariate regression analyses showed that the quartile of the natural logarithm of SIRI (ln-SIRI) was independently associated with mortality. Compared to patients in the first quartile (Q1), patients in the second quartile (Q2) and fourth quartile (Q4) were significantly associated with an increased risk of 30-day (HR = 2.031, 95% CI: 1.604–2.571, p < 0.001 and HR = 1.703, 95% CI: 1.32–2.195, p < 0.001) and 90-day all-cause mortality (HR = 2.063, 95% CI: 1.68–2.532, p < 0.001 and HR = 1.788, 95% CI: 1.435–2.227, p < 0.001), which is consistent with the results of the Kaplan-Meier analysis and the results of multivariate regression analyses by classifying into 12 groups based on dodeciles of SIRI. Curve fitting showed a curvilinear relationship and further threshold saturation effects showed that, for 90-day mortality, each unit increased in ln-SIRI, when the ln-SIRI level is less than 2.9, the patient's mortality increases by 23.2% (OR: 1.232; 95% CI: 1.111–1.367; p < 0.001); when the ln-SIRI is greater than 2.9 and less than 4.6, the patient's mortality decreases by 44.4% (OR: 0.554; 95% CI: 0.392–0.789; p = 0.001); when ln SIR > 4.6, the patient's mortality increases by 24.7% (OR: 1.247; 95% CI: 1.108–1.404; p < 0.001). Moreover, the length of stay in the hospital was lower in patients in the third quartile (Q3) (coefficient: −1.999; 95% CI: −2.834 – −1.165, p < 0.001). The length of stay in the ICU was higher in patients in Q2 and Q4 (coefficient: 0.685;95% CI: 0.243–1.128; p = 0.0024 and coefficient: 0.989;95% CI: 0.528–1.451; p < 0.001). Furthermore, SIRI may outperform NLR in predicting short-term mortality.ConclusionSIRI is an independent risk factor for 30- and 90-day mortality, and length of stay in ICU for critical AMI patients.

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Section: Discussionmentioning

confidence: 99%

A nonlinear relationship between systemic inflammation response index and short-term mortality in patients with acute myocardial infarction: a retrospective study from MIMIC-IV

Wang¹,

Chen²

2023

Front. Cardiovasc. Med.

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Thrombocytopenia and In-hospital outcomes in patients with acute ischemic stroke undergoing intravenous thrombolysis: Findings from a nationwide registry study in China

Xu,

Liu,

Zhou

et al. 2024

Journal of Stroke and Cerebrovascular Diseases

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Prognostic value of thrombocytopenia during hospitalizations in intracerebral hemorrhage patients

Feng,

Luo,

et al. 2024

Front. Neurol.

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BackgroundThe thrombocytopenia influences prognoses of critically ill patients. There are few studies exploring the prognostic value of thrombocytopenia among ICH patients. We perform this study to explore the correlation between thrombocytopenia at different timepoints of hospitalizations and mortality of ICH.MethodsICH patients recorded in the Medical Information Mart for Intensive Care-III were selected for this observational study. The thrombocytopenia, defined as platelet <150 × 109/L, was divided into three categories: baseline thrombocytopenia (thrombocytopenia occurred at admission), acquired thrombocytopenia (thrombocytopenia developed since the second day after admission), multiple thrombocytopenia (baseline thrombocytopenia + acquired thrombocytopenia). The main outcome in this study was the 30-day mortality of ICH patients. The univariate and multivariate logistic regression was sequentially performed to discover risk factors of mortality and confirm the correlation between thrombocytopenia groups and mortality of ICH.Results66.5% of 902 ICH patients did not experience the thrombocytopenia since admission. 2.2, 14.5 and 16.7% ICH patients showed the baseline thrombocytopenia, acquired thrombocytopenia initial and multiple thrombocytopenia, respectively. The GCS did not show significant difference between thrombocytopenia groups (p = 0.118). The multiple thrombocytopenia group had the highest incidence of mechanical ventilation (p = 0.041), mortality (p < 0.001), and the longest length of ICU stay (p < 0.001), length of hospital stay (p < 0.001). The multivariate logistic regression found age (p < 0.001), GCS (p < 0.001), glucose (p = 0.013), mechanical ventilation (p = 0.002) was correlated with the mortality of ICH patients. Only the multiple thrombocytopenia group showed significant influence on the mortality of ICH (p = 0.002) in the multivariate logistic regression.ConclusionSingle initial thrombocytopenia at admission dose not influence the mortality of ICH patients. ICH patients experiencing both initial thrombocytopenia and acquired thrombocytopenia have significantly higher mortality risk. The blood platelet level of ICH patients should be monitored continuously during hospitalizations to detect the thrombocytopenia and identify the high risk of poor prognosis.

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Is Thrombocytopenia an In-Hospital Mortality Risk Factor among Patients with Acute Ischemic Stroke? A Propensity Score-Matched Analysis from the MIMIC-IV Database

Cited by 3 publications

References 28 publications

A nonlinear relationship between systemic inflammation response index and short-term mortality in patients with acute myocardial infarction: a retrospective study from MIMIC-IV

A nonlinear relationship between systemic inflammation response index and short-term mortality in patients with acute myocardial infarction: a retrospective study from MIMIC-IV

Thrombocytopenia and In-hospital outcomes in patients with acute ischemic stroke undergoing intravenous thrombolysis: Findings from a nationwide registry study in China

Prognostic value of thrombocytopenia during hospitalizations in intracerebral hemorrhage patients

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