Tianjin Medical Journal

Tianjin Medical Journal ›› 2020, Vol. 48 ›› Issue (4): 279-283.doi: 10.11958/20193076

• Clinical Study • Previous Articles     Next Articles

Predictive values of early changes of platelet in 28-day mortality of patients with#br# severe heat stroke #br#

LI Ya-jie1, YU Jian-feng2△, ZHOU Yi2, YANG Qiao-yun2, ZHU Qi-lian2, LI Yong-chang2   

  1. 1 Department of Emergency, 2 Department of Intensive Care Unit, the Affiliated Hospital of Nanjing Medical University,
    Changzhou No. 2 People    ’s Hospital, Changzhou 213003, China
  • Received:2019-10-16 Revised:2020-01-10 Published:2020-04-15 Online:2020-06-23
  • Contact: YU Jian-feng E-mail:275871455@qq.com

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Abstract: Objective To explore the predictive value of early changes of platelet in the evaluation of 28-day prognosis
in the patients with severe heat stroke. Methods A retrospective study was conducted. The patients with severe heat stroke
admitted to the Second People’s Hospital of Changzhou from September 2010 to September 2018 were enrolled. These
patients were divided into survival group and death group according to 28-day outcome. The general condition and platelet
counting at 0 (PLT0), 72 hours (PLT72) after admission were collected. Receiver operating characteristic curve (ROC) was
plotted according to the platelet counting, the changes of platelet (ΔPLT), the change rates of platelet (ΔPLT%) and acute
physiology and chronic health status score (APACHEⅡ) for evaluating the predictive value of 28-day prognosis. KaplanMeier survival curve was used to analyze the 28-day cumulative survival rate between two groups of patients, who were subdivided according to the PLT0, PLT72, ΔPLT% and APACHEⅡ scores. Results (1) A total of 116 patients with severe heat stroke were enrolled in this study, including 90 cases in the survival group and 26 cases in the death group. The mortality was 22.4%. The rate of using vasoactive drugs, the length of invasive mechanical ventilation and APACHE Ⅱ scores were significantly higher in the death group than those in the survival group (P＜0.05). (2) The platelet levels showed the downward trend in both groups. Values of PLT0 and PLT72 were significantly lower in the death group than those in the survival group (P＜0.05). Meanwhile, the decrease ranges of ΔPLT and ΔPLT% were significantly larger in the death group  than those in the survival group (P＜0.05). (3) ROC curve analysis showed that values of APACHEⅡ scores, the PLT0, PLT72
and ΔPLT% could predict 28-day mortality in the patients with severe heat stroke, with the largest area under ROC curve
0.841 of PLT
72 (P＜0.05). (4) Kaplan-Meier survival analysis showed that the 28-day survival rate was significantly higher
than the cut-off value when the PLT
0 and PLT72 were higher (both P＜0.05). Conclusion The PLT at 72 hours after
admission may play an important role in predicting prognosis of the patients with severe heat stroke, The continuous decline
of PLT indicates poor prognosis in patients with severe heat stroke.

Key words: platelet count, severe heart stroke, death, prognosis

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