Correlation between thrombopoietin and inflammatory factors, platelet indices, and thrombosis in patients with sepsis: A retrospective study

doi:10.12998/wjcc.v10.i13.4072

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May 6, 2022 (publication date) through Jan 3, 2025

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. May 6, 2022; 10(13): 4072-4083
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4072

Table 1 Characteristics of the patients

Clinical information	Total (n = 200)	Control group (n = 110)	Sepsis group (n = 90)	P value
Age, yr	66 (54, 75)	64 (51, 71)	71 (57, 80)	0.002
Sex, male, n (%)	109.0 (54.5)	55.0 (50.0)	54.0 (60.0)	0.158
Hypertension, n (%)		40.0 (36.4)
Infection site
Lungs, n (%)			22.0 (24.4)
Abdomen, n (%)			54 (60)
Skin and soft tissue infections, n (%)			4.0 (4.4)
Central nervous system infection, n (%)			1.0 (1.1)
Others, n (%)			9 (10)
SOFA, n (%)			5 (3, 7)
WBC, × 10⁹/L	9.20 (7.15, 13.58)	8.03 (6.55, 10.29)	13.12 (8.80, 18.39)	< 0.001
N#, × 10⁹/L	7.02 (4.88, 11.47)	5.75 (4.11, 7.28)	10.69 (7.24, 16.58)	< 0.001
RBC, × 10¹²/L	4.30 (3.67, 4.77)	4.44 (4.13, 4.88)	3.83 (3.24, 4.53)	< 0.001
Hb, g/L	129.5 (107.0, 145.0)	134.5 (126.0, 148.0)	110.5 (98.0, 136.0)	< 0.001
PLT, × 10⁹/L	221.0 (159.5, 276.0)	241 (198, 283)	174.5 (118, 251)	< 0.001
PDW, fL	11.9 (10.6, 13.5)	11.80 (10.55, 12.95)	11.90 (10.60, 14.15)	0.343
P-LCR	0.28 (0.23, 0.34)	0.280 (0.230, 0.325)	0.30 (0.23, 0.37)	0.059
MPV, fL	10.4 (9.8, 11.2)	10.3 (9.8, 11.0)	10.5 (9.9, 11.6)	0.035
TPO, pg/mL	37.91 (6.10, 107.91)	12.45 (0.64, 46.09)	86.45 (30.55, 193.1)	< 0.001
IL-21, pg/mL	506 (418, 566)	436 (366, 493)	565 (524, 610)	< 0.001
IL-6, pg/mL	16.7 (4.6, 219.0)	5.0 (2.0, 12.0)	310.4 (41.9, 1582.4)	< 0.001
hs-CRP, mg/L	10.8 (1.6, 114.4)	2.1 (0.8, 6.1)	130.7 (58.4, 196.5)	< 0.001
PCT, ng/mL			10.26 (0.97, 31.70)
TBIL, µmol/L	11.05 (8.5, 16.9)	10.10 (7.75, 14.00)	14.25 (9.60, 23.00)	< 0.001
Cre, µmol/L	78 (60, 133)	69 (55, 87)	120.5 (73.0, 187.0)	< 0.001
TnI, ng/mL				< 0.001
≥ 0.01, n (%)	61.0 (30.7)	3.0 (2.7)	58.0 (65.2)
< 0.01, n (%)	138.0 (69.3)	107.0 (97.3)	31.0 (34.8)
Oxygenation index				< 0.001
≥ 400, n (%)	124.0 (64.9)	110 (100)	14.0 (17.3)
< 400, n (%)	67.0 (35.1)	0 (0)	67.0 (82.7)
MAP, mmHg				< 0.001
≥ 70, n (%)	161.0 (80.9)	110.0 (100.0)	51.0 (57.3)
< 70, n (%)	38.0 (19.1)	0 (0)	38.0 (42.7)
DD, µg/mL	0.960 (0.340, 2.795)	0.38 (0.22, 0.82)	3.120 (1.395, 6.440)	< 0.001
PT, s	12.50 (11.60, 14.05)	11.8 (11.2, 12.5)	14.0 (13.1, 15.4)	< 0.001
APTT, s	27.15 (24.95, 30.60)	26.4 (24.7, 27.8)	30.1 (26.5, 34.6)	< 0.001
TT, s	16.2 (15.3, 17.2)	16.60 (15.75, 17.40)	15.7 (14.8, 16.7)	< 0.001
INR	1.090 (1.010, 1.225)	1.03 (0.97, 1.09)	1.22 (1.14, 1.34)	< 0.001
FIB, g/L	3.450 (2.750, 4.655)	2.91 (2.58, 3.48)	4.58 (3.65, 5.95)	< 0.001

All data are shown as the median (P25, P75) or n (%). SOFA: Sequential organ failure assessment; N#: Neutrophile; WBC: White blood cell count; RBC: Red blood cell count; Hb: Hemoglobin concentration; PLT: Platelet count; PDW: Platelet distribution width; P-LCR: Platelet large-cell ratio; MPV: Mean platelet volume; TPO: Thrombopoietin; IL: Interleukin; hs-CRP: High-sensitivity C-reactive protein; PCT: Procalcitonin; TBIL: Total bilirubin; Cre: Creatinine; TnI: Troponin I; MAP: Mean arterial pressure; DD: D-dimer; PT: Prothrombin time; APTT: Activated partial thromboplastin time; TT: Thrombin time; INR: International normalized ratio; FIB: Fibrinogen.

Table 2 Univariable/multivariable analyses of sepsis

	Univariable			Multivariable
	OR	95%CI	P	OR	95%CI	P value
Age, yr	1.025	1.005-1.045	0.013	1.022	0.967-1.081	0.436
Gender
Male	Reference
Female	0.667	0.379-1.171	0.158
WBC	1.230	1.140-1.328	< 0.001	1.317	1.007-1.722	0.044
N#	1.315	1.202-1.439	< 0.001
RBC	0.404	0.272-0.600	< 0.001	1.398	0.376-5.197	0.617
Hb	0.972	0.960-0.985	< 0.001
TPO	1.016	1.010-1.022	< 0.001	1.021	1.005-1.037	0.009
IL-21	1.020	1.015-1.026	< 0.001	1.016	1.003-1.029	0.019
IL-6	1.066	1.039-1.093	< 0.001
hs-CRP	1.054	1.036-1.073	< 0.001
PLT	0.993	0.990-0.997	< 0.001	0.996	0.984-1.008	0.523
PDW	1.116	0.995-1.251	0.06
MPV	1.439	1.082-1.915	0.012	1.876	0.784-4.49	0.158
TBIL	1.084	1.04-1.13	< 0.001	1.023	0.925-1.131	0.658
Cre	1.005	1.001-1.008	0.004	0.993	0.981-1.005	0.26
TnI
≥ 0.01	66.731	19.556-227.712	< 0.001	55.199	5.686-535.903	0.001
< 0.01	Reference
DD	1.608	1.326-1.951	< 0.001	1.089	0.941-1.259	0.253
PT	2.677	2.004-3.576	< 0.001	2.235	1.097-4.554	0.027
APTT	1.310	1.190-1.443	< 0.001	1.057	0.809-1.381	0.684
TT	0.943	0.822-1.082	0.404
FIB	2.594	1.917-3.509	< 0.001	0.85	0.407-1.774	0.665

Variables with P < 0.05 in univariate analysis were entered in multivariate analysis, while variables with strong collinearity or correlation were excluded: IL-6, hs-CRP, PDW, N#, and Hb. OR: Odds ratio; CI: Confidence interval; WBC: White blood cell count; N#: Neutrophils; RBC: Red blood cell count; Hb: Hemoglobin concentration; TPO: Thrombopoietin; IL: Interleukin; hs-CRP: High-sensitivity C-reactive protein; PLT: Platelet count; PDW: Platelet distribution width; MPV: Mean platelet volume; TBIL: Total bilirubin; Cre: Creatinine; TnI: Troponin I; MAP: Mean arterial pressure; DD: D-dimer; PT: Prothrombin time; APTT: Activated partial thromboplastin time; TT: Thrombin time; INR: International normalized ratio; FIB: Fibrinogen.

Table 3 Correlation analyses between indicators and thrombopoietin

Factor	Spearman correlation coefficient	P value
Age, yr	0.138	0.052
TPO	1
IL-21	0.362	< 0.001
IL-6	0.385	< 0.001
hsCRP	0.531	< 0.001
PLT	-0.177	0.012
PDW	-0.043	0.556
MPV	0.034	0.641
P-LCR	0.017	0.819
TBIL	0.118	0.098
Cre	0.219	0.002
DD	0.453	< 0.001
PT	0.311	< 0.001
APTT	0.203	0.004
TT	-0.307	< 0.001
INR	0.310	< 0.001
FIB	0.438	< 0.001
WBC	0.176	0.013
N#	0.235	0.001
RBC	-0.246	< 0.001
Hb	-0.209	0.003

TPO: Thrombopoietin; IL-21: Interleukin-21; IL-6: Interleukin-6; hs-CRP: High-sensitivity C-reactive protein; PLT: Platelet count; PDW: Platelet distribution width; MPV: Mean platelet volume; P-LCR: Platelet large cell ratio; DD: D-dimer; TBIL: Total bilirubin; Cre: Creatinine; PT: Prothrombin time; APTT: Activated partial thromboplastin time; TT: Thrombin time; INR: International normalized ratio; FIB: Fibrinogen; WBC: White blood cell count; N#: Neutrophils; RBC; Red blood cell count; Hb: Hemoglobin concentration.

Citation: Xu WH, Mo LC, Shi MH, Rao H, Zhan XY, Yang M. Correlation between thrombopoietin and inflammatory factors, platelet indices, and thrombosis in patients with sepsis: A retrospective study. World J Clin Cases 2022; 10(13): 4072-4083
URL: https://www.wjgnet.com/2307-8960/full/v10/i13/4072.htm
DOI: https://dx.doi.org/10.12998/wjcc.v10.i13.4072