잠시만 기다려 주세요. 로딩중입니다.

Clinical Implications of Thrombocytopenia at Cardiogenic Shock Presentation: Data from a Multicenter Registry

Yonsei Medical Journal 2020년 61권 10호 p.851 ~ 859
이혁희, 홍성진, 안철민, 양정훈, 권현철, 김정순, 김병극, 고영국, 최동훈, 홍명기, 장양수,
소속 상세정보
이혁희 ( Lee Hyeok-Hee ) - Yonsei University College of Medicine Department of Preventive Medicine
홍성진 ( Hong Sung-Jin ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
안철민 ( Ahn Chul-Min ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
양정훈 ( Yang Jeong-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
권현철 ( Gwon Hyeon-Cheol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
김정순 ( Kim Jung-Sun ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
김병극 ( Kim Byeong-Keuk ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
고영국 ( Ko Young-Guk ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
최동훈 ( Choi Dong-Hoon ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
홍명기 ( Hong Myeong-Ki ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
장양수 ( Jang Yang-Soo ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine

Abstract


Purpose: Thrombocytopenia (platelet count <150×103/μL) is associated with poor outcomes in various critical illness settings. However, the prognostic value of platelet count in patients with cardiogenic shock (CS) remains unclear.

Materials and Methods: We enrolled 1202 patients between January 2014 and December 2018 from a multicenter retrospective-prospective cohort registry of CS. Clinical characteristics and treatment outcomes were compared between the patients with and without thrombocytopenia.

Results: At presentation with CS, 244 (20.3%) patients had thrombocytopenia. The patients with thrombocytopenia had lower blood pressure, hemoglobin level, and worse liver and renal functions compared to the patients without. During hospitalization, the patients with thrombocytopenia had more frequent gastrointestinal bleeding (10.5% vs. 3.8%, p=0.009), sepsis (8.3% vs. 2.6%, p=0.013), requirement of renal replacement therapy (36.5% vs. 18.9%, p<0.001), requirement of mechanical ventilation (65.2% vs. 54.4%, p=0.003), longer intensive care unit stay (8 days vs. 4 days, p<0.001), and thirty-day mortality (40.2% vs. 28.5%, p<0.001) compared to those without. In addition, the platelet count was an independent predictor of 30-day mortality (per 103/μL decrease; adjusted hazard ratio: 1.002, 95% confidence interval: 1.000?1.003, p=0.021).

Conclusion: Thrombocytopenia at CS presentation was associated with worse clinical findings, higher frequencies of complications, and longer stay at the intensive care unit. Also, thrombocytopenia was independently associated with increased 30-day mortality. (Clinical trial registration No. NCT02985008).

키워드

Cardiogenic shock; thrombocytopenia; platelet; mortality; prognosis

원문 및 링크아웃 정보

 

등재저널 정보

SCI(E)
MEDLINE
KCI
KoreaMed