The prognostic value of platelet aggregation in patients with sepsis.
arachidonic acid and adenosine diphosphate
platelet aggregation rate
prognosis sepsis
Journal
Allergologia et immunopathologia
ISSN: 1578-1267
Titre abrégé: Allergol Immunopathol (Madr)
Pays: Singapore
ID NLM: 0370073
Informations de publication
Date de publication:
2024
2024
Historique:
received:
15
11
2023
accepted:
16
01
2024
medline:
9
5
2024
pubmed:
9
5
2024
entrez:
9
5
2024
Statut:
epublish
Résumé
This study aims to investigate the relevance of platelet aggregation markers, specifically arachidonic acid (AA) and adenosine diphosphate (ADP), in relation to the prognosis of sepsis patients. A cohort of 40 sepsis patients was included and stratified, based on their 28-day post-treatment prognosis, into two groups: a survival group (n = 31) and a severe sepsis group (n = 9. Then, their various clinical parameters, including patient demographics, platelet counts (PLT), inflammatory markers, and platelet aggregation rates (PAR) induced by AA and ADP between the two groups, were compared. Long-term health implications of sepsis were assessed using the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, and logistic regression analysis was conducted to evaluate the prognostic significance of PAR in sepsis patients. Patients with severe sepsis exhibited significantly elevated levels of procalcitonin (PCT), platelet adhesion rates, and PAR induced by ADP (P < 0.05), but having lower PLT (P < 0.05), compared to those in the survival group. Logistic regression analysis demonstrated that PAR induced by ADP was a protective factor in predicting prognosis in sepsis patients (P < 0.01). Activation of platelets in sepsis intensifies inflammatory response. Patients with sepsis whose ADP-induced PAR was < 60% displayed significant impairment in platelet aggregation function, and had higher mortality rate. Monitoring ADP-induced PAR is crucial for management of sepsis.
Sections du résumé
BACKGROUND
BACKGROUND
This study aims to investigate the relevance of platelet aggregation markers, specifically arachidonic acid (AA) and adenosine diphosphate (ADP), in relation to the prognosis of sepsis patients.
METHODS
METHODS
A cohort of 40 sepsis patients was included and stratified, based on their 28-day post-treatment prognosis, into two groups: a survival group (n = 31) and a severe sepsis group (n = 9. Then, their various clinical parameters, including patient demographics, platelet counts (PLT), inflammatory markers, and platelet aggregation rates (PAR) induced by AA and ADP between the two groups, were compared. Long-term health implications of sepsis were assessed using the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, and logistic regression analysis was conducted to evaluate the prognostic significance of PAR in sepsis patients.
RESULTS
RESULTS
Patients with severe sepsis exhibited significantly elevated levels of procalcitonin (PCT), platelet adhesion rates, and PAR induced by ADP (P < 0.05), but having lower PLT (P < 0.05), compared to those in the survival group. Logistic regression analysis demonstrated that PAR induced by ADP was a protective factor in predicting prognosis in sepsis patients (P < 0.01).
CONCLUSIONS
CONCLUSIONS
Activation of platelets in sepsis intensifies inflammatory response. Patients with sepsis whose ADP-induced PAR was < 60% displayed significant impairment in platelet aggregation function, and had higher mortality rate. Monitoring ADP-induced PAR is crucial for management of sepsis.
Identifiants
pubmed: 38721951
doi: 10.15586/aei.v52i3.1039
doi:
Substances chimiques
Adenosine Diphosphate
61D2G4IYVH
Arachidonic Acid
27YG812J1I
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
17-21Déclaration de conflit d'intérêts
The authors stated that there were no conflicts of interest to declare.
Références
1. Song JC. The mechanism and monitoring of disseminated intravascular coagulation in sepsis J Med Grad Stud. 2017;30(7):703–708. 10.16571/j.cnki.1008-8199.2017.07.006
doi: 10.16571/j.cnki.1008-8199.2017.07.006
2. Alcamo AM, Pang D, Bashir DA, Carcillo JA, Nguyen TC, Aneja RK. Role of damage-associated molecular patterns and uncontrolled inflammation in pediatric sepsis-induced multiple organ dysfunction syndrome. J Pediatr Intensive Care. 2019, Mar;8(1):25–31. 10.1055/s-0038-1675639
doi: 10.1055/s-0038-1675639
3. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016, Feb 23;315(8):801–10. 10.1001/jama.2016.0287
doi: 10.1001/jama.2016.0287
4. Zhao X, Wang K, Zuo P, Liu Y, Zhang M, Xie S, et al. Early decrease in blood platelet count is associated with poor prognosis in COVID-19 patients-indications for predictive, preventive, and personalized medical approach. EPMA J. 2020 Jun;11(2):139–45. 10.1007/s13167-020-00208-z
doi: 10.1007/s13167-020-00208-z
5. Sun J and Wu WD. Risk factors and prognosis analysis of sepsis associated thrombocytopenia. Chin J Crit Care Med (Electr Ed.). 2014;7(3):177–81.
6. Claushuis TA, van Vught LA, Scicluna BP, Wiewel MA, Klein Klouwenberg PM, Hoogendijk AJ, et al. Thrombocytopenia is associated with a dysregulated host response in critically ill sepsis patients. Blood. 2016, Jun 16;127(24):3062–72. 10.1182/blood-2015-11-680744
doi: 10.1182/blood-2015-11-680744
7. Yaguchi A, Lobo FL, Vincent JL, Pradier O. Platelet function in sepsis. J Thromb Haemost. 2004, Dec;2(12):2096–10210.1111/j.1538-7836.2004.01009.x
doi: 10.1111/j.1538-7836.2004.01009.x
8. Song JC, Liu SY, Zhu F, Wen AQ, Ma LH, Li WQ, et al. Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China. Mil Med Res. 2020, Apr 3;7(1):15. 10.1186/s40779-020-00244-w
doi: 10.1186/s40779-020-00244-w
9. Zhao YZ, Li CS, Jia YM. Prognostic evaluation of procalcitonin combined with interleukin-6 in patients with emergency sepsis. Chin J Emerg Med. 2014:56–60.
10. Chen QS, Wang XY. Research progress on the mechanism of platelets in various organ dysfunction in sepsis. Clin Med Res Prac. 2020;5(17):197–8. 10.19347/j.cnki.2096-1413.202017073
doi: 10.19347/j.cnki.2096-1413.202017073
11. Bian YP, Xu J, Deng XJ, Cheng H, She LP. A study on the role of platelet parameters in the severity and prognosis evaluation of sepsis in the elderly. Prac Geriat Med. 2019,33(06):548–51.
12. Davies GR, Mills GM, Lawrence M, Battle C, Morris K, Hawkins K, et al. The role of whole blood impedance aggregometry and its utilisation in the diagnosis and prognosis of patients with systemic inflammatory response syndrome and sepsis in acute critical illness. PLOS One. 2014;9(9):e108589. 10.1371/journal.pone.0108589
doi: 10.1371/journal.pone.0108589
13. Dan G, Hu LN, Jiang ZY, Liu Y, Geng X, Xie J, et al. Examination and clinical significance of platelet function related indicators in patients with sepsis. Lab Med Clin Pract. 2015;12(09):1191–2, 1195.