The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation

Background: The relationship between the magnitude of platelet count decrease and mortality in post-cardiotomy cardiogenic shock (PCS) patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) has not been well-reported. This study was designed to evaluate the association betwee...

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Autores principales:	Liangshan Wang, Juanjuan Shao, Chengcheng Shao, Hong Wang, Ming Jia, Xiaotong Hou
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	post-cardiotomy cardiogenic shock venoarterial extracorporeal membrane oxygenation platelet count mortality decrease Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/dcca8bb1ccbf4a9d91c320cecdd43891
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spelling	oai:doaj.org-article:dcca8bb1ccbf4a9d91c320cecdd438912021-11-04T07:14:19ZThe Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation2296-858X10.3389/fmed.2021.733946https://doaj.org/article/dcca8bb1ccbf4a9d91c320cecdd438912021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.733946/fullhttps://doaj.org/toc/2296-858XBackground: The relationship between the magnitude of platelet count decrease and mortality in post-cardiotomy cardiogenic shock (PCS) patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) has not been well-reported. This study was designed to evaluate the association between the relative decrease in platelet count (RelΔplatelet) at day 1 from VA-ECMO initiation and in-hospital mortality in PCS patients.Methods: Patients (n = 178) who received VA-ECMO for refractory PCS between January 2016 and December 2018 at the Beijing Anzhen Hospital were reviewed retrospectively. Multivariable logistic regression analyses were performed to assess the association between RelΔplatelet and in-hospital mortality.Results: One hundred and sixteen patients (65%) were weaned from VA-ECMO, and 84 patients (47%) survived to hospital discharge. The median [interquartile range (IQR)] time on VA-ECMO support was 5 (3–6) days. The median (IQR) RelΔ platelet was 41% (26–59%). Patients with a RelΔ platelet ≥ 50% had an increased mortality compared to those with a RelΔ platelet < 50% (57 vs. 37%; p < 0.001). A large RelΔplatelet (≥50%) was independently associated with in-hospital mortality after controlling for potential confounders (OR 8.93; 95% CI 4.22–18.89; p < 0.001). The area under the receiver operating characteristic curve for RelΔ platelet was 0.78 (95% CI, 0.71–0.85), which was better than that of platelet count at day 1 (0.69; 95% CI, 0.61–0.77).Conclusions: In patients receiving VA-ECMO for post-cardiotomy cardiogenic shock, a large relative decrease in platelet count in the first day after ECMO initiation is independently associated with an increased in-hospital mortality.Liangshan WangJuanjuan ShaoChengcheng ShaoHong WangMing JiaXiaotong HouFrontiers Media S.A.articlepost-cardiotomy cardiogenic shockvenoarterial extracorporeal membrane oxygenationplatelet countmortalitydecreaseMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	post-cardiotomy cardiogenic shock venoarterial extracorporeal membrane oxygenation platelet count mortality decrease Medicine (General) R5-920
spellingShingle	post-cardiotomy cardiogenic shock venoarterial extracorporeal membrane oxygenation platelet count mortality decrease Medicine (General) R5-920 Liangshan Wang Juanjuan Shao Chengcheng Shao Hong Wang Ming Jia Xiaotong Hou The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
description	Background: The relationship between the magnitude of platelet count decrease and mortality in post-cardiotomy cardiogenic shock (PCS) patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) has not been well-reported. This study was designed to evaluate the association between the relative decrease in platelet count (RelΔplatelet) at day 1 from VA-ECMO initiation and in-hospital mortality in PCS patients.Methods: Patients (n = 178) who received VA-ECMO for refractory PCS between January 2016 and December 2018 at the Beijing Anzhen Hospital were reviewed retrospectively. Multivariable logistic regression analyses were performed to assess the association between RelΔplatelet and in-hospital mortality.Results: One hundred and sixteen patients (65%) were weaned from VA-ECMO, and 84 patients (47%) survived to hospital discharge. The median [interquartile range (IQR)] time on VA-ECMO support was 5 (3–6) days. The median (IQR) RelΔ platelet was 41% (26–59%). Patients with a RelΔ platelet ≥ 50% had an increased mortality compared to those with a RelΔ platelet < 50% (57 vs. 37%; p < 0.001). A large RelΔplatelet (≥50%) was independently associated with in-hospital mortality after controlling for potential confounders (OR 8.93; 95% CI 4.22–18.89; p < 0.001). The area under the receiver operating characteristic curve for RelΔ platelet was 0.78 (95% CI, 0.71–0.85), which was better than that of platelet count at day 1 (0.69; 95% CI, 0.61–0.77).Conclusions: In patients receiving VA-ECMO for post-cardiotomy cardiogenic shock, a large relative decrease in platelet count in the first day after ECMO initiation is independently associated with an increased in-hospital mortality.
format	article
author	Liangshan Wang Juanjuan Shao Chengcheng Shao Hong Wang Ming Jia Xiaotong Hou
author_facet	Liangshan Wang Juanjuan Shao Chengcheng Shao Hong Wang Ming Jia Xiaotong Hou
author_sort	Liangshan Wang
title	The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
title_short	The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
title_full	The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
title_fullStr	The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
title_full_unstemmed	The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation
title_sort	relative early decrease in platelet count is associated with mortality in post-cardiotomy patients undergoing venoarterial extracorporeal membrane oxygenation
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/dcca8bb1ccbf4a9d91c320cecdd43891
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The Relative Early Decrease in Platelet Count Is Associated With Mortality in Post-cardiotomy Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation

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