title: Association of the Plasma Platelet-Derived Microparticles to Platelet Count Ratio with Hospital Mortality and Disseminated Intravascular Coagulopathy in Critically Ill Patients.
abstract: OBJECTIVE
  The role of platelet-derived microparticles (PDMPs) in the crosstalk between coagulopathy and inflammation in critically ill patients remains unclear. The aim of this cohort observational study was to investigate the associations between the PDMP levels and hospital mortality or disseminated intravascular coagulopathy (DIC).
  
  
  METHODS
  This study included 119 patients who were admitted to the ICU. The PDMP levels were measured using an enzyme-linked immunosorbent assay three times a week, for a total of 372 samples. We calculated the maximum (max) PDMP value, max PDMP/platelet (PDMP/Plts) ratio (converted to the PDMP levels per 10(4) platelets) and nadir platelet count during the ICU stay. Baseline patient data and scores, including the Japanese Association for Acute Medicine (JAAM) DIC score, were collected, and potential predictors were analyzed for possible associations with hospital mortality.
  
  
  RESULTS
  The max PDMP/Plts ratio was significantly different comparing the survivors (n=98: median, 2.54) and non-survivors (n=21: median 17.59; p＜0.001). There was a weak but statistically significant negative correlation between the max PDMP level and nadir platelet count (r=-0.332, p＜0.001). The max PDMP level and max PDMP/Plts ratio were higher in the DIC group (81.48 and 9.27, respectively) than in the non-DIC group (34.88 and 2.35, p=0.001 and p＜0.001, respectively). The max PDMP/Plts ratio was the only variable found to be independently associated with hospital mortality according to a multivariate logistic regression analysis.
  
  
  CONCLUSIONS
  PDMPs are involved in the development of DIC but are not related to hospital mortality. There is a good association between the PDMP/Plts ratio and hospital mortality and/or DIC in critically ill patients.
authors: Department of Critical and Intensive Medicine, Shiga University of Medical Science.
authors: Masatsugu
authors: M
authors: Ohuchi
authors: Kazunori
authors: K
authors: Fujino
authors: Takuma
authors: T
authors: Kishimoto
authors: Tetsunobu
authors: T
authors: Yamane
authors: Tetsu
authors: T
authors: Hamamoto
authors: Takahisa
authors: T
authors: Tabata
authors: Yasuyuki
authors: Y
authors: Tsujita
authors: Mikiko
authors: M
authors: Matsushita
authors: Kan
authors: K
authors: Takahashi
authors: Kazuhiro
authors: K
authors: Matsumura
authors: Yutaka
authors: Y
authors: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055252:Cell-Derived Microparticles; D015331:Cohort Studies; D016638:Critical Illness; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology; D010976:Platelet Count; D011237:Predictive Value of Tests; D055815:Young Adult