Risk factors of sepsis-associated thrombocytopenia and the construction of prediction model
Liu Yichang
Zheng Hengheng
Zhu Jianjun
Feng Hui
Jiang Yuhao
Du Xin
Shen Bin
Abstract：Objective To study the risk factors of thrombocytopenia in the patients with sepsis and to construct the prediction model.Methods A retrospective study was conducted to collect the clinical data of sepsis patients admitted to the ICU of the Second Affiliated Hospital of Soochow University from January 2019 to December 2021,the patients were divided into throm bocytopenia group and normal group according to whether the thrombocytopenia occurred during hospitalization.The clinical data were compared between the two groups,and Logistic regression analysis was performed to screen out the independent risk factors associated with sepsis-associated thrombocytopenia,the prediction model was established based on independent risk factors.The area under the receiver operating characteristic(ROC)curve(AUC),calibration curve and decision curve analysis(DCA)were used to evaluate the predictive efficacy and clinical value of the model.Results A total of 380 patients with sepsis were enrolled in the study,187 with thrombocytopenia and 193 with normal platelet.Multivariate Logistic regression analysis identified platelet-larger cell ratio(P-LCR),procalcitonin(PCT)and sequential organ failure assessment(SOFA)scores as independent risk factors for sepsis-associated thrombocytopenia.The area under the curve(AUC),sensitivity and specificity of prediction model based on independent risk factors were 0.910,91.0％and 73.5％,respectively.The calibration curve showed that there was a good consistency between the prediction of the model and the results of actual observation.The superiority of the fitting model was proved.DCA showed that the clinical benefit ratio was good when the threshold probability of the predictive model fluctuated in the range of 0.01-0.93.Conclusions P-LCR,PCT and SOFA scores are independent risk factors for thrombocytopenia in sepsis.The clinical predictive model based on three independent risk factors has high diagnostic efficacy and good clinical practicability.
Keywords：SepsisThrombocytopeniaRisk factorsPrediction modelPlatelet-larger cell ratioProcalcitoninSequential organ failure assessment
Publication Date：2024-08-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 672-677 )