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已发表论文
血小板计数变化与急性胰腺炎患者感染性胰腺坏死、手术干预及死亡发生率的关系：一项回顾性队列研究
Authors Sun W , Zhao B, Wang Z, Mao E, Li Y, Che Z
Received 10 July 2025
Accepted for publication 4 December 2025
Published 13 December 2025 Volume 2025:18 Pages 17421—17432
DOI https://doi.org/10.2147/JIR.S552811
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Alberto Caminero
Wenwu Sun,1,2,* Bing Zhao,2,* Zhiyuan Wang,3,* Enqiang Mao,2 Yang Li,1 Zaiqian Che2
1Department of Emergency Medicine, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zaiqian Che, Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email chezaiqian@163.com Yang Li, Department of Emergency Medicine, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, People’s Republic of China, Email dpliyang@tmmu.edu.cn
Background: Acute pancreatitis (AP) is a common abdominal emergency, often associated with severe complications such as infected pancreatic necrosis (IPN) and the need for surgical intervention. Platelet count dynamics during the course of AP may be linked to disease progression and outcomes.
Purpose: This study aimed to identify clinically meaningful longitudinal platelet count patterns in AP.
Methods: Longitudinal platelet count patterns were derived using group-based trajectory modeling (GBTM). Generalized additive models were used to demonstrate the association between platelet counts and outcomes.
Results: 2225 AP patients are enrolled in the analysis and classified into 5 subclasses using GBTM. Class 1 (n=269) had a low initial platelet count, which increased slowly; Class 2 (n=983) and Class 4 (n=597) had different initial platelet count levels, but fluctuated within the normal range; Class 3 (n=225) and Class 5 (n=151) had different initial platelet count levels, but both increased beyond the normal range. A significantly decreased risk of infected pancreatic necrosis (IPN) is observed in classes 2 (OR 0.3, CI 0.16– 0.55) and 4 (OR 0.14, CI 0.06– 0.33), but the risk was comparable among classes 1 (ref), 3 (OR 1.25, CI 0.66– 2.41), and 5 (OR 0.69, CI 0.28– 1.56). The risks of the surgical interventions were similar. However, the 30-day and 90-day mortality rates were significantly lower in classes 2, 3, 4, and 5 than in class 1. Generalized additive models also demonstrated the lowest risk of IPN, surgical intervention, and in-hospital mortality as platelet counts remained within the normal range.
Conclusion: Patients with platelet counts within the normal range had the lowest risk of IPN, surgical intervention, and mortality. Both thrombocytopenia and thrombocytosis indicate an increased risk of IPN and surgical intervention; however, mortality is significantly increased only in patients with thrombocytopenia.
Keywords: acute pancreatitis, platelet count, infected pancreatic necrosis, mortality, trajectory model
1Department of Emergency Medicine, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zaiqian Che, Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email chezaiqian@163.com Yang Li, Department of Emergency Medicine, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, People’s Republic of China, Email dpliyang@tmmu.edu.cn
Background: Acute pancreatitis (AP) is a common abdominal emergency, often associated with severe complications such as infected pancreatic necrosis (IPN) and the need for surgical intervention. Platelet count dynamics during the course of AP may be linked to disease progression and outcomes.
Purpose: This study aimed to identify clinically meaningful longitudinal platelet count patterns in AP.
Methods: Longitudinal platelet count patterns were derived using group-based trajectory modeling (GBTM). Generalized additive models were used to demonstrate the association between platelet counts and outcomes.
Results: 2225 AP patients are enrolled in the analysis and classified into 5 subclasses using GBTM. Class 1 (n=269) had a low initial platelet count, which increased slowly; Class 2 (n=983) and Class 4 (n=597) had different initial platelet count levels, but fluctuated within the normal range; Class 3 (n=225) and Class 5 (n=151) had different initial platelet count levels, but both increased beyond the normal range. A significantly decreased risk of infected pancreatic necrosis (IPN) is observed in classes 2 (OR 0.3, CI 0.16– 0.55) and 4 (OR 0.14, CI 0.06– 0.33), but the risk was comparable among classes 1 (ref), 3 (OR 1.25, CI 0.66– 2.41), and 5 (OR 0.69, CI 0.28– 1.56). The risks of the surgical interventions were similar. However, the 30-day and 90-day mortality rates were significantly lower in classes 2, 3, 4, and 5 than in class 1. Generalized additive models also demonstrated the lowest risk of IPN, surgical intervention, and in-hospital mortality as platelet counts remained within the normal range.
Conclusion: Patients with platelet counts within the normal range had the lowest risk of IPN, surgical intervention, and mortality. Both thrombocytopenia and thrombocytosis indicate an increased risk of IPN and surgical intervention; however, mortality is significantly increased only in patients with thrombocytopenia.
Keywords: acute pancreatitis, platelet count, infected pancreatic necrosis, mortality, trajectory model