{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T02:51:18Z","timestamp":1770691878614,"version":"3.49.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012165","name":"Key Technologies Research and Development Program","doi-asserted-by":"publisher","award":["2020YFC0861000"],"award-info":[{"award-number":["2020YFC0861000"]}],"id":[{"id":"10.13039\/501100012165","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["CMB 20-381"],"award-info":[{"award-number":["CMB 20-381"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81801901"],"award-info":[{"award-number":["81801901"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-B-115"],"award-info":[{"award-number":["2022-PUMCH-B-115"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Sepsis associated thrombocytopenia (SAT) is a common complication of sepsis. We designed this study to investigate factors influencing SAT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients with sepsis (2984 in Peking union medical college hospital [PUMCH] database, 13165 in eICU Collaborative Research [eICU] database, 11101 in Medical Information Mart for Intensive Care IV [MIMIC-IV] database) were enrolled. Variables included basic information, comorbidities, and organ functions. Multi-variable logistic regression models and artificial neural network model were applied to determine the factors related to SAT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Main results<\/jats:title>\n<jats:p>Age and body mass index (BMI) were inversely correlated with the incidence of SAT (p-value 0.175 and 0.049 [PUMCH], p-value 0.000 and 0.000 [eICU], p-value 0.000 and 0.000 [MIMIC-IV]). Hematologic malignancies and other malignancies were positively correlated with the incidence of SAT (p-value 0.000 and 0.000 [PUMCH], p-value 0.000 and 0.000 [eICU], p-value 0.000 and 0.020 [MIMIC-IV]) except other malignancies was inversely correlated with the incidence of SAT in PUMCH database. Norepinephrine (NE) equivalents, total bilirubin (TBIL) and creatinine were positively correlated with the incidence of SAT (p-value 0.000, 0.000 and 0.011 [PUMCH], p-value 0.028, 0.000 and 0.013 [eICU], p-value 0.028, 0.000 and 0.027 [MIMIC-IV]). PaO2 \/ FiO2 was inversely correlated with the incidence of SAT in PUMCH database (p-value 0.021 [PUMCH]), while it was positively correlated with the incidence of SAT (p-value 0.000 [MIMIC-IV]). PaO2 \/ FiO2 and SAT was not related (p-value 0.111 [eICU]). TBIL, hematologic malignancies, PaO2 \/ FiO2 and NE equivalents ranked in the top five significant variables in all three datasets.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Hematologic malignancies and other malignancies were positively correlated with the incidence of SAT. NE equivalents, TBIL and creatinine were positively correlated with the incidence of SAT. TBIL, hematologic malignancies, PaO2 \/ FiO2 and NE equivalents ranked in the top significant variables in factors influencing SAT.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318887","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T18:30:21Z","timestamp":1739212221000},"page":"e0318887","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors influencing sepsis associated thrombocytopenia (SAT): A multicenter retrospective cohort study"],"prefix":"10.1371","volume":"20","author":[{"given":"Lu","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieqing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4291-5108","authenticated-orcid":true,"given":"Xiang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of China National Critical Care Quality Control Centre Group (China-NCCQC)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"issue":"12","key":"pone.0318887.ref001","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1007\/s00134-024-07694-z","article-title":"Sepsis: key insights, future directions, and immediate goals. A review and expert opinion.","volume":"50","author":"I Martin-Loeches","year":"2024","journal-title":"Intensive Care Med"},{"issue":"3","key":"pone.0318887.ref002","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/ejh.13549","article-title":"Current understanding and future implications of sepsis-induced thrombocytopenia","volume":"106","author":"S Ghimire","year":"2021","journal-title":"Eur J Haematol"},{"key":"pone.0318887.ref003","article-title":"Impaired Megakaryopoiesis due to Aberrant Macrophage Polarization via BTK\/Rap1\/NF-kappaB Pathway in Sepsis-induced Thrombocytopenia","author":"Z Zhang","year":"2024","journal-title":"Mol Ther"},{"key":"pone.0318887.ref004","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.ijid.2020.06.045","article-title":"Recombinant human thrombopoietin in critically ill patients with sepsis-associated thrombocytopenia: A clinical study","volume":"98","author":"Y Liu","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"5","key":"pone.0318887.ref005","first-page":"e25421","article-title":"Sepsis and Thrombocytopenia: A Nowadays Problem.","volume":"14","author":"DA Gonzalez","year":"2022","journal-title":"Cureus"},{"issue":"4","key":"pone.0318887.ref006","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":"H Zhou","year":"2022","journal-title":"Platelets"},{"issue":"12","key":"pone.0318887.ref007","doi-asserted-by":"crossref","first-page":"e0315643","DOI":"10.1371\/journal.pone.0315643","article-title":"Use of vasopressors in patients with acute kidney injury on continuous kidney replacement therapy.","volume":"19","author":"A Ramesh","year":"2024","journal-title":"PLoS One"},{"issue":"11","key":"pone.0318887.ref008","doi-asserted-by":"crossref","first-page":"e0313944","DOI":"10.1371\/journal.pone.0313944","article-title":"Evaluation of risk factors for 14-day and 30-day mortality among treatment regimens against Pseudomonas aeruginosa resistant to carbapenem but susceptible to traditional antipseudomonal non-carbapenem beta-lactam agents.","volume":"19","author":"S Supreeyasakon","year":"2024","journal-title":"PLoS One"},{"key":"pone.0318887.ref009","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jcrc.2020.11.002","article-title":"Vasopressor dose equivalence: A scoping review and suggested formula","volume":"61","author":"S Goradia","year":"2021","journal-title":"J Crit Care"},{"key":"pone.0318887.ref010","article-title":"Optimal PaO2 is 130\u2013160 mmHg in the first week for sepsis patients in ICU: a retrospective cohort study based on MIMIC-IV database","author":"H Chen","year":"2024","journal-title":"Shock"},{"issue":"12","key":"pone.0318887.ref011","doi-asserted-by":"crossref","first-page":"e0314872","DOI":"10.1371\/journal.pone.0314872","article-title":"Association of serum potassium levels with mortality in critically ill patients with sepsis during hospitalization.","volume":"19","author":"G Zhao","year":"2024","journal-title":"PLoS One"},{"issue":"11","key":"pone.0318887.ref012","doi-asserted-by":"crossref","first-page":"e0313132","DOI":"10.1371\/journal.pone.0313132","article-title":"Explainable machine learning for early prediction of sepsis in traumatic brain injury: A discovery and validation study.","volume":"19","author":"W Liu","year":"2024","journal-title":"PLoS One"},{"issue":"16","key":"pone.0318887.ref013","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1089\/ars.2021.0056","article-title":"Divergent Sepsis Pathophysiology in Older Adults","volume":"35","author":"MS Kingren","year":"2021","journal-title":"Antioxid Redox Signal"},{"issue":"9","key":"pone.0318887.ref014","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s00134-017-4718-z","article-title":"The status of intensive care medicine research and a future agenda for very old patients in the ICU.","volume":"43","author":"H Flaatten","year":"2017","journal-title":"Intensive Care Med"},{"issue":"2","key":"pone.0318887.ref015","first-page":"126","article-title":"Sepsis in old age: review of human and animal studies.","volume":"5","author":"ME Starr","year":"2014","journal-title":"Aging Dis"},{"issue":"6","key":"pone.0318887.ref016","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/CCM.0000000000005801","article-title":"Korean Sepsis Alliance I: Obesity Paradox and Functional Outcomes in Sepsis: A Multicenter Prospective Study.","volume":"51","author":"HJ Yeo","year":"2023","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0318887.ref017","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12871-017-0434-z","article-title":"The obesity conundrum in sepsis.","volume":"17","author":"PY Ng","year":"2017","journal-title":"BMC Anesthesiol"},{"issue":"2","key":"pone.0318887.ref018","first-page":"e6929","article-title":"Sepsis Patients in Critical Care Units with Obesity: Is Obesity Protective?","volume":"12","author":"C Kalani","year":"2020","journal-title":"Cureus"},{"issue":"1","key":"pone.0318887.ref019","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/jcsm.12904","article-title":"Obesity attenuates inflammation, protein catabolism, dyslipidaemia, and muscle weakness during sepsis, independent of leptin.","volume":"13","author":"W Vankrunkelsven","year":"2022","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"3","key":"pone.0318887.ref020","doi-asserted-by":"crossref","first-page":"E433","DOI":"10.1152\/ajpendo.00380.2020","article-title":"Obesity protects against sepsis-induced and norepinephrine-induced white adipose tissue browning","volume":"321","author":"C Li","year":"2021","journal-title":"Am J Physiol Endocrinol Metab"},{"issue":"1","key":"pone.0318887.ref021","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/ALN.0000000000000192","article-title":"Obesity-induced hyperleptinemia improves survival and immune response in a murine model of sepsis","volume":"121","author":"D Siegl","year":"2014","journal-title":"Anesthesiology"},{"issue":"1","key":"pone.0318887.ref022","doi-asserted-by":"crossref","first-page":"56","DOI":"10.5005\/jp-journals-10071-23469","article-title":"Epidemiology, Clinical Characteristics, and Prognostic Factors in Critically Ill Patients with Hematolymphoid Malignancy.","volume":"25","author":"SS Siddiqui","year":"2021","journal-title":"Indian J Crit Care Med"},{"issue":"1","key":"pone.0318887.ref023","doi-asserted-by":"crossref","first-page":"45","DOI":"10.6004\/jnccn.2021.7046","article-title":"Outcomes and Predictors of 28-Day Mortality in Patients With Hematologic Malignancies and Septic Shock Defined by Sepsis-3 Criteria.","volume":"20","author":"NK Manjappachar","year":"2022","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"pone.0318887.ref024","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1186\/s12879-021-06243-z","article-title":"Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance.","volume":"21","author":"A Amanati","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"12","key":"pone.0318887.ref025","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.clml.2017.07.009","article-title":"Sepsis and Acute Myeloid Leukemia: A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals.","volume":"17","author":"IA Malik","year":"2017","journal-title":"Clin Lymphoma Myeloma Leuk"},{"issue":"1","key":"pone.0318887.ref026","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1186\/s12879-022-07647-1","article-title":"Antibody waning after immunosuppressive chemotherapy and immunomodulators, re-immunization considerations in pediatric patients with malignancy and chronic immune thrombocytopenic purpura.","volume":"22","author":"B Abdolkarimi","year":"2022","journal-title":"BMC Infect Dis"},{"issue":"9","key":"pone.0318887.ref027","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1164\/rccm.201905-1083LE","article-title":"Norepinephrine for Early Shock Control in Sepsis","volume":"200","author":"M Tung","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"9","key":"pone.0318887.ref028","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1164\/rccm.201905-1007LE","article-title":"Early Use of Norepinephrine for Sepsis: Promising Results That Require Confirmation","volume":"200","author":"N El Beze","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"pone.0318887.ref029","doi-asserted-by":"crossref","first-page":"1271098","DOI":"10.3389\/fimmu.2023.1271098","article-title":"Impact of norepinephrine on immunity and oxidative metabolism in sepsis","volume":"14","author":"J Thoppil","year":"2023","journal-title":"Front Immunol"},{"issue":"6","key":"pone.0318887.ref030","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1164\/rccm.202002-0339OC","article-title":"Norepinephrine Dysregulates the Immune Response and Compromises Host Defense during Sepsis","volume":"202","author":"RF Stolk","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"8","key":"pone.0318887.ref031","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"161","key":"pone.0318887.ref032","doi-asserted-by":"crossref","DOI":"10.1183\/16000617.0059-2021","article-title":"Impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome.","volume":"30","author":"M Gierhardt","year":"2021","journal-title":"Eur Respir Rev"},{"issue":"3","key":"pone.0318887.ref033","doi-asserted-by":"crossref","first-page":"250","DOI":"10.4103\/sja.sja_1216_20","article-title":"The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery.","volume":"15","author":"M Licker","year":"2021","journal-title":"Saudi J Anaesth"},{"issue":"4","key":"pone.0318887.ref034","doi-asserted-by":"crossref","DOI":"10.1177\/2045894020915831","article-title":"Inhibition of ornithine decarboxylase restores hypoxic pulmonary vasoconstriction in endotoxemic mice.","volume":"10","author":"PH Gebauer","year":"2020","journal-title":"Pulm Circ"},{"issue":"6","key":"pone.0318887.ref035","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1177\/1098612X18792106","article-title":"Multiorgan dysfunction syndrome in feline sepsis: prevalence and prognostic implication.","volume":"21","author":"R Troia","year":"2019","journal-title":"J Feline Med Surg"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318887","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T18:30:37Z","timestamp":1739212237000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318887"}},"subtitle":[],"editor":[{"given":"Hossein Ali","family":"Adineh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318887","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,10]]}}}