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소아 중환자의 예후 인자로서 혈소판 감소증과 변화 양상의 유용성

Title
 소아 중환자의 예후 인자로서 혈소판 감소증과 변화 양상의 유용성
Other Titles
 Usefulness of Thrombocytopenia and Changes in Platelet Counts as Prognostic Markers in Pediatric Intensive Care Units
Authors
 손명현; 김규언; 김경원; 한윤기; 이희선; 김환수; 김민정; 박현빈; 김윤희
Issue Date
2013
Journal Title
 Korean Journal of Critical Care Medicine (대한중환자의학회지)
ISSN
 1229-4802
Citation
 Korean Journal of Critical Care Medicine (대한중환자의학회지), Vol.28(2) : 93~100, 2013
Abstract
Background : Thrombocytopenia has been shown to be a useful predictor of mortality in adult intensive care units (ICUs). The aim of this study is to assess whether the level of platelet count at ICU admission and the changes in platelet counts can predict mortality in the pediatric ICU (PICU). Methods : Platelet counts were checked daily for at least 4 days in a total of 303 children who were admitted to the ICU. We compared the initial platelet counts and changes in platelet counts between survivors and non-survivors. A multivariable logistic regression model, a receiver operating characteristic curve and a linear mixed model were used. Results : The initial platelet count was significantly lower in non-survivors when compared to survivors. Multivariate analysis demonstrated that platelet count <120 × 109/L (Odds ratio, 4.913; 95% confidence interval 2.451-9.851; p < 0.0001) was an independent predictor of mortality. In the case of children with thrombocytopenia (<120 × 109/L) at admission to the ICU, the platelet counts increased serially in survivors, whereas non-survivors maintained their decreased platelet counts. In the case of children without thrombocytopenia, the platelet counts decreased most on day 3 in non-survivors. Conclusions : At admission to the ICU, thrombocytopenia defined as a platelet count <120 × 109/L can be a useful predictor of mortality in children. In children who had initial thrombocytopenia, the serial increase of platelet counts can be related to increased survival, whereas in children who did not have initial thrombocytopenia, more than a 10% decrease of platelet counts on day 3 can be related to mortality.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87219
DOI
10.4266/kjccm.2013.28.2.93
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Pediatrics
Yonsei Authors
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