The predictive value of mean platelet volume to platelet count ratio combined with APACHEIIs for short-term prognosis of patients with acute kidney injury treated by continuous renal replacement therapy

Objective To investigate the predictive value of mean platelet volume(MPV)to platelet count(PLT)ratio(MPR)combined with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scoring for the short-term prognosis of patients with acute renal injury(AKI)treated with continuous renal replacement therapy(CRRT).Methods A total of 138 AKI patients who received CRRT in our hospital from January 2016 to October 2019 were retrospectively included.According to their survival conditions at discharge,they were divided into survival group(n=80)and death group(n=58).The value of MPR,APACHE Ⅱ score and their combination for predicting the death of AKI patients was analyzed by ROC curve.The independent risk factors for poor prognosis were evaluated by multivariate logistic regression analysis.Results (1)MPV,MPR and APACHE Ⅱ scores of patients in the death group were significantly higher than those in the survival group(11.9±1.1)fl vs.(11.0±1.1)fl,P<0.01;0.11(0.09,0.14)vs.0.08(0.06,0.11),P<0.01;(25.0±3.5)score vs.(19.5±3.4)score,P<0.01.PLT count of patients in death group was significantly lower than that of survival group(108.9±28.0)×10⁹/L vs.(146.8±41.4)×10⁹/L,P<0.01.(2)The cutoff values of MPR,APACHE Ⅱ score and the combination to predict the death of AKI patients were 0.08,24 points and 0.54,respectively.The AUC of death in AKI patients predicted by MPR combined with APACHE Ⅱ was significantly higher than that of MPR and APACHE Ⅱ alone0.892(0.828-0.938)vs.0.737(0.656-0.809),P<0.01;0.892(0.828-0.938)vs.0.838(0.766-0.896),P<0.05.(3)APACHE Ⅱ score(≥ 24),MPR combined with APACHE Ⅱ score(APACHE Ⅱ score ≥ 24,and MPR ≥ 0.08),diuretics administration were the independent risk factors for poor prognosis in AKI patientsHR(95%CI):2.311(1.034-5.166),3.533(1.541-8.098),34.816(7.475-162.149),all P<0.05.Conclusions MPR combined with APACHE Ⅱ score can well predict the short-term prognosis of AKI patients treated with CRRT.