title: An elevated percentage of reticulated platelet is associated with increased mortality in septic shock patients.
abstract: Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP%) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP% as a predictor of mortality in septic shock patients.This was a prospective study conducted in a surgical critical care center of a Chinese tertiary care hospital. Consecutive septic shock patients were enrolled at admission. Age- and sex-matched non-septic patients were recruited as control patients. RP% was determined by flow cytometry in 68 septic shock patients and 68 controls.Compared with survivors, septic patients who died presented with a significantly higher RP% (P < 0.001). The area under the receiver-operating characteristic curve for the RP% association with mortality was 0.867 (95 % CI 0.780-0.953, P < 0.001). Kaplan-Meier survival curves showed that mortality risk was significantly different when patients were stratified based on RP% (P < 0.001). This association was preserved in a multi-logistic regression analysis that included clinical confounders (P < 0.014).This prospective study demonstrates that increased RP% identifies septic shock patients who have a high risk of death. RP% has the potential to act as a marker for patient stratification in future clinical trials.
authors.affiliation: From the Department of General Surgery, Jinling Hospital, Medical School of Nanjing University (QW, JR, DH, GL, NA, GW, GG, JC, XW, SL, YL, YZ, JL); and Department of Hematology, First Affiliated Hospital of Nanjing University of Medicine, Nanjing, China (PJ).
authors.forename: Qin
authors.initials: Q
authors.lastname: Wu
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.forename: Dong
authors.initials: D
authors.lastname: Hu
authors.forename: Pengjun
authors.initials: P
authors.lastname: Jiang
authors.forename: Guanwei
authors.initials: G
authors.lastname: Li
authors.forename: Nadeem
authors.initials: N
authors.lastname: Anjum
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.forename: Guosheng
authors.initials: G
authors.lastname: Gu
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Zhao
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D018806:APACHE; D000328:Adult; D015415:Biomarkers; D001792:Blood Platelets / Q000166:cytology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality*; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers