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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1458238

Non-linear Relationship Between Platelet Count and 28-day Mortality in Critically Ill Patients With Infective Endocarditis: a Retrospective Cohort Study from MIMIC IV Database

Provisionally accepted
Yingxiu Huang Yingxiu Huang *Ting Ao Ting Ao Peng Zhen Peng Zhen *Ming Hu Ming Hu *
  • Beijing Luhe Hospital, Capital Medical University, Beijing, China

The final, formatted version of the article will be published soon.

    Background The relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis (IE) is currently not well established. Objective: This study aims to investigate the impact of platelet count on 28-day mortality in critically ill patients with infective endocarditis. Methods: A retrospective cohort study was conducted involving 450 participants diagnosed with infective endocarditis and admitted to intensive care units (ICU). Vital signs, laboratory parameters and comorbidity were collected for all participants to analyze the association between platelet count and 28-day mortality. In order to assess the independent association between platelet count and 28-day mortality, we employed multivariable cox hazard regression analyses and smooth curve fitting. A further analysis was conducted using a two-piecewise linear regression model to examine the nonlinear association between platelet count and in-hospital mortality. Results: A total of 450 critically ill patients with infective endocarditis were included in the study. The mean age was 57.4 years, and 64.2% were male. The overall 28-day mortality rate was 20%. A non-linear relationship was observed between platelet count and 28-day mortality. Two different slopes were identified, with correlations between platelet count and 28-day mortality in patients with IE differing significantly below and above the inflection point, which was approximately 141 K/μL. On the left side of the inflection point, the hazard ratio was 0.990 (hazard ratio: 0.990, 95% confidence interval: 0.982–0.997, p = 0.006). However, on the right side of the inflection point, the hazard ratio increased marginally to 1.0004 (HR: 1.0004, 95% CI: 0.997–1.004, p = 0.825). Notably, the association lacked statistical significance on the right side of the inflection point. Conclusion: A nonlinear association between platelet count and 28-day mortality was observed in critically ill patients with infective endocarditis. The optimal platelet count associated with the lowest risk of 28-day mortality was above 141 k/μL.

    Keywords: Platelet Count, Infective endocarditis, critically ill patients, Nonlinear relationship, Mortality, MIMIC-IV

    Received: 02 Jul 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Huang, Ao, Zhen and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yingxiu Huang, Beijing Luhe Hospital, Capital Medical University, Beijing, China
    Peng Zhen, Beijing Luhe Hospital, Capital Medical University, Beijing, China
    Ming Hu, Beijing Luhe Hospital, Capital Medical University, Beijing, China

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