An elevated percentage of reticulated platelet is associated with increased mortality in septic shock patients

Abstract

Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP%) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP% as a predictor of mortality in septic shock patients. This was a prospective study conducted in a surgical critical care center of a Chinese tertiary care hospital. Consecutive septic shock patients were enrolled at admission. Age- and sex-matched non-septic patients were recruited as control patients. RP% was determined by flow cytometry in 68 septic shock patients and 68 controls. Compared with survivors, septic patients who died presented with a significantly higher RP% (P<0.001). The area under the receiver-operating characteristic curve for the RP% association with mortality was 0.867 (95 % CI 0.780-0.953, P<0.001). Kaplan-Meier survival curves showed that mortality risk was significantly different when patients were stratified based on RP% (P<0.001). This association was preserved in a multi-logistic regression analysis that included clinical confounders (P<0.014). This prospective study demonstrates that increased RP% identifies septic shock patients who have a high risk of death. RP% has the potential to act as a marker for patient stratification in future clinical trials.