Key result
High baseline platelets linked to ~67% higher odds of poor functional outcome at discharge.
Why the study?
The association between baseline platelet count and short-term prognosis including functional outcome and early neurological deterioration in ischemic stroke patients was unclear.
Is baseline platelet count associated with short-term functional outcome and early neurological deterioration in patients with ischemic stroke?
Cohort (n=385)
No
Is baseline platelet count associated with short-term functional outcome and early neurological deterioration in patients with ischemic stroke?
Odds Ratio: 1.674 (95% CI 1.253–6.681)
Absolute Event Rate: 25.7% vs 10.4%
p-value: p=0.013
Both low and high baseline platelet counts are associated with worse short-term functional outcomes and early neurological deterioration in ischemic stroke patients compared to normal-high counts.
High platelet count was associated with poor short-term stroke outcome; leaves open causal role and need for prospective validation.
Background and aims Platelets play an important role in homeostasis however, they have also been associated with increased mortality after myocardial infarction. In the present study, we investigated whether platelet count is associated with differences in the short-term prognosis at the time of hospital discharge and early neurological deterioration in ischemic stroke patients. Methods Patients with ischemic stroke were enrolled from among 661 cerebrovascular disease patients admitted between January 2018 and December 2020. Patients who received hyperacute treatment, had a pre-onset modified Rankin scale (mRS) ≥ 3, transient ischemic attack, or active malignant disease were excluded. The platelet count was divided into quartiles (Q1-4) according to the number of patients, and the relationship between platelet count and prognosis was assessed using multivariable analysis. Results In total, 385 patients were included in the study. Regarding the functional outcome by platelet count, there was a significant increase in mRS ≥ 3 at discharge in the Q4 (range: 243–1327 × 109/L, p = 0.013, ORs: 1.674, 95%CI: 1.253–6.681) group compared to the Q3 (range: 205–242 × 109/L) group even after adjusting for factors with P < 0.2 in univariate analysis. Furthermore, the frequency of neurological deterioration (NIHSS ≥ 4) within 1 week was significantly lower in the Q3 group than in the Q1 (range; 19–173 × 109/L) and Q4 groups even after adjustment (Q1; p = 0.020 ORs: 6.634, 95%CI: 1.352–32.557, Q4; p = 0.007 ORs: 8.765, 95%CI: 1.827–42.035). Conclusion Platelet count at onset may affect the prognosis of cerebral infarction and early neurological deterioration. This study may help clarify the pathogenesis of cerebral infarction to improve prognosis.
No takes yet. Share an insight, caveat, or question.
Kanazawa et al. (2022) conducted a cohort in Acute ischemic stroke (n=385). High baseline platelet count (Quartile 4: 243-1327 × 10^9/L) vs. Reference baseline platelet count (Quartile 3: 205-242 × 10^9/L) was evaluated on Modified Rankin scale (mRS) ≥ 3 at discharge (OR 1.674, 95% CI 1.253-6.681, p=0.013). A high baseline platelet count (243-1327 × 10^9/L) significantly increased the odds of a poor functional outcome (mRS ≥ 3) at discharge compared to a reference count of 205-242 × 10^9/L (OR 1.674).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: