Abstract:
This study aimed to investigate the relationship between platelet count (PC) and mortality in patients with hemorrhagic stroke (HS). The research reviewed data from 10,466 patients hospitalized in 208 hospitals in the United States from January 1, 2014, to December 31, 2015. Of these, 3262 HS patients were included in the primary analysis for those admitted to the intensive care unit (ICU). The average age of these patients was 67.05 years, with 52.79% being male. The median PC was (221.67 ± 73.78) × 109/L. Multivariate logistic regression analysis revealed that PC was a protective factor for mortality in HS patients (OR = 0.98, 95% CI 0.97-1.00, P < 0.05). Additionally, a non-linear association between PC and mortality in HS patients was found using a generalized additive model (GAM) and smooth curve fitting (penalty spline method). For the first time, a recursive algorithm identified the inflection point of platelet count as 194 × 109/L. On the left side of the inflection point, for every increase of 10 units in platelet count, the mortality rate of HS patients decreases by 10%. The study demonstrates a non-linear relationship between PC and the risk of mortality in HS patients. A platelet counts higher than the inflection point (194 × 109/L) may be a significant intervention to reduce mortality in HS patients.
摘要:
本研究旨在探讨血小板计数(PC)与出血性卒中(HS)患者死亡率的关系。该研究回顾了2014年1月1日至2015年12月31日在美国208家医院住院的10,466名患者的数据。其中,3262例HS患者被纳入重症监护病房(ICU)的主要分析。这些患者的平均年龄为67.05岁,52.79%是男性。PC中位数为(221.67±73.78)×109/L。多因素logistic回归分析显示PC是HS患者死亡的保护因素(OR=0.98,95%CI0.97~1.00,P<0.05)。此外,使用广义加性模型(GAM)和平滑曲线拟合(惩罚样条法)发现HS患者PC与死亡率之间存在非线性关联.第一次,递归算法确定血小板计数的拐点为194×109/L。在拐点的左侧,血小板计数每增加10个单位,HS患者的死亡率降低了10%。该研究表明PC与HS患者死亡风险之间存在非线性关系。血小板计数高于拐点(194×109/L)可能是降低HS患者死亡率的重要干预措施。