Thrombosis research · 2025
Risk factors for thrombocytopenia in adult patients with sepsis: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Han Pufan, Qi Jiaqian, Zhang Ziyan, Wang Peng, Song Xiaofei, Han Yue
Аннотация
BACKGROUND: Sepsis-induced thrombocytopenia (SIT) is a frequent hematological complication in critically ill patients. However, the independent risk factors for SIT remain controversial. This meta-analysis aims to identify independent predictors of SIT in adult septic patients.
OBJECTIVE: To identify risk factors for SIT and explore their potential implications for early risk stratification and platelet-targeted intervention in sepsis.
METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were searched from inception to April 2025. Studies reporting multivariable-adjusted associations between candidate risk factors and SIT were included. Data extraction and quality assessment were performed independently by two reviewers. Newcastle-Ottawa Scale was used for quality assessment. Pooled odds ratios (ORs) and mean differences (MDs) were calculated using RevMan 5.3 and Stata 15.0.
RESULTS: A total of 14 studies involving 14,316 septic patients were included. The pooled incidence of SIT was 37.9 %. In the primary analysis using the conventional threshold of PLT <100 × 109 L-1, elevated lactate, higher SOFA scores, and lower WBC count were associated with SIT. Subgroup analyses at PLT <150 × 109 L-1 yielded consistent results for lactate and WBC, while SOFA retained significance only at the stricter definition. No significant publication bias was detected.
CONCLUSIONS: This meta-analysis demonstrated that elevated serum lactate, higher SOFA scores, and lower white blood cell count are significantly associated with SIT. Given the structural overlap between SOFA score and thrombocytopenia, further studies are needed to validate its independent role. Early identification of these predictors may help improve risk stratification and clinical management in septic patients.
OBJECTIVE: To identify risk factors for SIT and explore their potential implications for early risk stratification and platelet-targeted intervention in sepsis.
METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were searched from inception to April 2025. Studies reporting multivariable-adjusted associations between candidate risk factors and SIT were included. Data extraction and quality assessment were performed independently by two reviewers. Newcastle-Ottawa Scale was used for quality assessment. Pooled odds ratios (ORs) and mean differences (MDs) were calculated using RevMan 5.3 and Stata 15.0.
RESULTS: A total of 14 studies involving 14,316 septic patients were included. The pooled incidence of SIT was 37.9 %. In the primary analysis using the conventional threshold of PLT <100 × 109 L-1, elevated lactate, higher SOFA scores, and lower WBC count were associated with SIT. Subgroup analyses at PLT <150 × 109 L-1 yielded consistent results for lactate and WBC, while SOFA retained significance only at the stricter definition. No significant publication bias was detected.
CONCLUSIONS: This meta-analysis demonstrated that elevated serum lactate, higher SOFA scores, and lower white blood cell count are significantly associated with SIT. Given the structural overlap between SOFA score and thrombocytopenia, further studies are needed to validate its independent role. Early identification of these predictors may help improve risk stratification and clinical management in septic patients.