{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:36:33Z","timestamp":1784133393439,"version":"3.55.0"},"reference-count":43,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018636","name":"Xuzhou Science and Technology Program","doi-asserted-by":"publisher","award":["KC21202"],"award-info":[{"award-number":["KC21202"]}],"id":[{"id":"10.13039\/501100018636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,15]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Given the high morbidity and mortality of patients with sepsis-associated thrombocytopenia (SATP) in the intensive care unit, this study retrospectively analysed the influencing factors for poor prognosis in patients with SATP using the MIMIC database, constructed a nomogram model and verified the predictive performance of the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The data from MIMIC-IV, V.2.2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical characteristics<\/jats:title>\n                    <jats:p>The clinical features of SATP, including demographics, comorbidities, vital signs, laboratory parameters, treatments and clinical management, were extracted from the MIMIC-IV database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>1409 patients with SATP were included in this study and randomly divided into a training set and a validation set in a ratio of 7:3. The least absolute shrinkage and selection operator and multivariable Cox regression analysis were used to determine the optimal predictors and establish a prediction model. The receiver operating characteristic curve, calibration curve and decision curve analysis (DCA) were used to verify the accuracy and application value of the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The nomogram model incorporates nine factors, including clinical characteristics, laboratory test indicators, comorbidities and treatment methods, which were identified as predictors of SATP and used to construct the model. The area under the curve of the model was 0.868 (95% CI: 0.794 to 0.942) in the training set and 0.836 (95% CI: 0.681 to 0.991) in the validation set. The calibration curve and DCA confirmed the clinical application value of the nomogram.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The constructed nomogram for predicting patients with SATP has favourable predictive ability and is helpful to further optimise clinical management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099691","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T02:35:45Z","timestamp":1754966145000},"page":"e099691","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV"],"prefix":"10.1136","volume":"15","author":[{"given":"Wei","family":"Ye","sequence":"first","affiliation":[{"name":"The Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, China"},{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sishui County People\u2019s Hospital, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shucun","family":"Liu","sequence":"additional","affiliation":[{"name":"The Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, China"},{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Li","sequence":"additional","affiliation":[{"name":"The Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, China"},{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Tang","sequence":"additional","affiliation":[{"name":"The Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, China"},{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8207-1600","authenticated-orcid":false,"given":"Jiaqiong","family":"Li","sequence":"additional","affiliation":[{"name":"The Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, China"},{"name":"Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"2025123106455510000_15.8.e099691.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"2025123106455510000_15.8.e099691.2","doi-asserted-by":"publisher","DOI":"10.1007\/S00134-021-06506-Y"},{"key":"2025123106455510000_15.8.e099691.3","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00063-016-0174-8","article-title":"Thrombopenie auf der Intensivstation","volume":"111","author":"Kn\u00f6bl","year":"2016","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"2025123106455510000_15.8.e099691.4","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13699"},{"key":"2025123106455510000_15.8.e099691.5","doi-asserted-by":"crossref","unstructured":"Assinger A , Schrottmaier WC , Salzmann M , et al . n.d. Platelets in Sepsis: An Update on Experimental Models and Clinical Data. Front Immunol 10. doi:10.3389\/fimmu.2019.01687","DOI":"10.3389\/fimmu.2019.01687"},{"key":"2025123106455510000_15.8.e099691.6","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017011817"},{"key":"2025123106455510000_15.8.e099691.7","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/2052-0492-1-9","article-title":"Thrombocytopenia in adult patients with sepsis: incidence, risk factors, and its association with clinical outcome","volume":"1","author":"Venkata","year":"2013","journal-title":"J Intensive Care"},{"key":"2025123106455510000_15.8.e099691.8","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200002000-00027"},{"key":"2025123106455510000_15.8.e099691.9","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/08820139.2017.1413113","article-title":"Modification of immunological features in human platelets during sepsis","volume":"47","author":"Raque","year":"2018","journal-title":"Immunol Invest"},{"key":"2025123106455510000_15.8.e099691.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","article-title":"MIMIC-IV, a freely accessible electronic health record dataset","volume":"10","author":"Johnson","year":"2023","journal-title":"Sci Data"},{"key":"2025123106455510000_15.8.e099691.11","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0703500604"},{"key":"2025123106455510000_15.8.e099691.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2009.07.005"},{"key":"2025123106455510000_15.8.e099691.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03866.x"},{"key":"2025123106455510000_15.8.e099691.14","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1080\/09537104.2021.1970124","article-title":"Thrombocytopenia and platelet count recovery in patients with sepsis-3: a retrospective observational study","volume":"33","author":"Zhou","year":"2022","journal-title":"Platelets"},{"key":"2025123106455510000_15.8.e099691.15","doi-asserted-by":"crossref","first-page":"3494","DOI":"10.3390\/ijms20143494","article-title":"Platelets Are Critical Key Players in Sepsis","volume":"20","author":"Vardon-Bounes","year":"2019","journal-title":"IJMS"},{"key":"2025123106455510000_15.8.e099691.16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-11-462432"},{"key":"2025123106455510000_15.8.e099691.17","doi-asserted-by":"crossref","unstructured":"Catalisano G , Ippolito M , Blanda A , et al . Effects of hyperoxemia in patients with sepsis \u2013 A post-hoc analysis of a multicentre randomized clinical trial. Pulmonology 2025;31. doi:10.1016\/j.pulmoe.2023.02.005","DOI":"10.1016\/j.pulmoe.2023.02.005"},{"key":"2025123106455510000_15.8.e099691.18","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1164\/rccm.202303-0560OC","article-title":"Conservative versus Liberal Oxygenation Targets in Intensive Care Unit Patients (ICONIC): A Randomized Clinical Trial","volume":"208","author":"van der Wal","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"key":"2025123106455510000_15.8.e099691.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2006.06.012"},{"key":"2025123106455510000_15.8.e099691.20","doi-asserted-by":"publisher","DOI":"10.1007\/s00109-007-0204-3"},{"key":"2025123106455510000_15.8.e099691.21","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-005-0023-3"},{"key":"2025123106455510000_15.8.e099691.22","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.medcli.2020.06.060","article-title":"Blood urea nitrogen to serum albumin ratio independently predicts 30-day mortality and severity in patients with Escherichia coli bacteraemia","volume":"157","author":"Zou","year":"2021","journal-title":"Medicina Cl\u00ednica"},{"key":"2025123106455510000_15.8.e099691.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05760-5"},{"key":"2025123106455510000_15.8.e099691.24","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1042\/CS20110233","article-title":"Protein metabolism and gene expression in skeletal muscle of critically ill patients with sepsis","volume":"122","author":"Klaude","year":"2012","journal-title":"Clin Sci"},{"key":"2025123106455510000_15.8.e099691.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.05.026"},{"key":"2025123106455510000_15.8.e099691.26","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/ijlh.13925","article-title":"Red cell distribution width and in\u2010hospital mortality in septic shock: A public database research","volume":"44","author":"Ding","year":"2022","journal-title":"Int J Lab Hematology"},{"key":"2025123106455510000_15.8.e099691.27","doi-asserted-by":"crossref","unstructured":"Zhang L , Yu C , Guo K , et al . Prognostic role of red blood cell distribution width in patients with sepsis: a systematic review and meta-analysis. BMC Immunol 2020;21. doi:10.1186\/s12865-020-00369-6","DOI":"10.1186\/s12865-020-00369-6"},{"key":"2025123106455510000_15.8.e099691.28","doi-asserted-by":"crossref","unstructured":"Ananthaseshan S , Bojakowski K , Sacharczuk M , et al . Red blood cell distribution width is associated with increased interactions of blood cells with vascular wall. Sci Rep 2022;12. doi:10.1038\/s41598-022-17847-z","DOI":"10.1038\/s41598-022-17847-z"},{"key":"2025123106455510000_15.8.e099691.29","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.11"},{"key":"2025123106455510000_15.8.e099691.30","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002074"},{"key":"2025123106455510000_15.8.e099691.31","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-4127-0"},{"key":"2025123106455510000_15.8.e099691.32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s40560-015-0105-4","article-title":"Lactate kinetics in sepsis and septic shock: a review of the literature and rationale for further research","volume":"3","author":"Chertoff","year":"2015","journal-title":"j intensive care"},{"key":"2025123106455510000_15.8.e099691.33","unstructured":"Digital NE . Hospital admitted patient care activity. n.d. Available: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/hospital-admitted-patient-care-activity"},{"key":"2025123106455510000_15.8.e099691.34","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2020-211111"},{"key":"2025123106455510000_15.8.e099691.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.09.006"},{"key":"2025123106455510000_15.8.e099691.36","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1182\/blood.2022017634","article-title":"How I diagnose and treat thrombocytopenia in geriatric patients","volume":"143","author":"Foy","year":"2024","journal-title":"Blood"},{"key":"2025123106455510000_15.8.e099691.37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530260048030"},{"key":"2025123106455510000_15.8.e099691.38","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000266755.75844.05"},{"key":"2025123106455510000_15.8.e099691.39","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206933"},{"key":"2025123106455510000_15.8.e099691.40","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1038\/nature21706","article-title":"The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors","volume":"544","author":"Lefran\u00e7ais","year":"2017","journal-title":"Nature New Biol"},{"key":"2025123106455510000_15.8.e099691.41","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pbio.3001109","article-title":"COVID-19 induces a hyperactive phenotype in circulating platelets","volume":"19","author":"Comer","year":"2021","journal-title":"PLoS Biol"},{"key":"2025123106455510000_15.8.e099691.42","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1152\/jappl.2000.89.4.1645","article-title":"Invited Review: Mechanisms of ventilator-induced lung injury: a perspective","volume":"89","author":"Dos Santos","year":"2000","journal-title":"J Appl Physiol"},{"key":"2025123106455510000_15.8.e099691.43","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/nrneph.2017.184","article-title":"Paradigms of acute kidney injury in the intensive care setting","volume":"14","author":"Kellum","year":"2018","journal-title":"Nat Rev Nephrol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-099691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:46:48Z","timestamp":1767192408000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-099691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":43,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bmjopen-2025-099691"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-099691","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}