Evidence map›Paper›PMID 28187736›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2017

Thrombocytopenia on the first day of emergency department visit predicts higher risk of acute kidney injury among elderly patients.

Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang, COGENT (COhort of GEriatric Nephrology in NTUH) study group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Observational
  5. Review
  6. Article
  7. Analysis of cytopenia in geriatric inpatients.Zeitschrift fur Gerontologie und Geriatrie · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Chia-Ter ChaoDepartment of Medicine, National Taiwan University Hospital Jinshan Branch, New Taipei City, Taiwan.
Hung-Bin TsaiDepartment of Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Chih-Kang ChiangGraduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan.
Jenq-Wen HuangDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 100, Taiwan. 007378@ntuh.gov.tw.
COGENT (COhort of GEriatric Nephrology in NTUH) study group
National Taiwan University · TWNational Taiwan University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFew studies have addressed risk factors for acute kidney injury (AKI) in geriatric patients. We investigated whether thrombocytopenia was a risk factor for AKI in geriatric patients with medical illnesses.

methodsA prospective cohort study was conducted, by recruiting elderly (≥65 years) patients who visited the emergency department (ED) for medical illnesses during 2014. They all received hemogram for platelet count determination, and were stratified according to the presence of thrombocytopenia (platelets, <150 K/μL) during their initial ED evaluation. They were prospectively followed up during their ED stay. We analyzed the relationship between the diagnosis of thrombocytopenia and subsequent AKI after ED stay, using Cox proportional hazard modeling, with platelet count as a continuous variable or thrombocytopenia as a categorical variable.

resultsOf 136 elderly patients (mean age of 80.7 ± 8.2 years, 40% with chronic kidney disease, and 39% with diabetes) enrolled, 22.8% presented with thrombocytopenia, without differences in baseline renal function. After a mean ED stay of 4.4 ± 2.1 days, 41.9% developed AKI (52.6% Kidney Disease Improving Global Outcomes [KDIGO] grade 1, 24.6% grade 2, and 22.8% grade 3). Patients with higher AKI severity had stepwise lower platelet counts compared to those without AKI. The Cox proportional hazard model revealed that lower platelet count as a continuous variable (hazard ratio [HR] 0.984, 95% confidence interval [CI] 0.975-0.994) and as a categorical variable (presence of thrombocytopenia) (HR 1.86, 95% CI 1.06-3.27) increased the risk of AKI. The sensitivity analyses accounting for nephrotoxic medications use, including non-steroidal anti-inflammatory drugs, vancomycin, and contrast, yielded similar results. DISCUSSION: Thrombocytopenia is common among ED-visiting elderly, and the potential relationship between platelet counts and the risk of AKI suggests the utility of checking hemogram for those at-risk ofdeveloping adverse renal events.

conclusionThrombocytopenia on initial presentation might indicate an increased risk of AKI among elderly patients with medical illnesses.

Indexed as

Emergency Service, HospitalAcute Kidney InjuryAgedAged, 80 and overFemaleHumansKidney Function TestsMalePlatelet CountProspective StudiesRisk AssessmentRisk FactorsThrombocytopeniaAcute kidney injuryElderlyEmergency departmentGeriatricsPlateletsThrombocytopenia

Identifiers

PMID28187736
PMCPMC5303206
OpenAlexW2587052731

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.