Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study
Background The aspartate aminotransferase-to-platelet ratio index (APRI) is an effective non-invasive marker for chronic liver dysfunction. Given that heat stroke patients often suffer from poor prognosis due to multi-organ involvement, with liver injury and coagulation dysfunction being of particul...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2478485 |
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| author | Min Wang Yun Li Yuan Cao Meng-Meng Yang Fu-Jing Liu Jie Jiao Sheng-Yuan Wang Bin Song Lu Wang Yi-Qi Wu Hong-Jun Kang |
| author_facet | Min Wang Yun Li Yuan Cao Meng-Meng Yang Fu-Jing Liu Jie Jiao Sheng-Yuan Wang Bin Song Lu Wang Yi-Qi Wu Hong-Jun Kang |
| author_sort | Min Wang |
| collection | DOAJ |
| description | Background The aspartate aminotransferase-to-platelet ratio index (APRI) is an effective non-invasive marker for chronic liver dysfunction. Given that heat stroke patients often suffer from poor prognosis due to multi-organ involvement, with liver injury and coagulation dysfunction being of particular concern, this study aims to investigate whether APRI can comprehensively reflect liver injury and coagulation dysfunction in heat stroke patients and explore its relationship with 28-day mortality.Methods This retrospective study analysed electronic medical records from patients treated at 57 grade A tertiary hospitals in China from May 2005 to May 2024. The primary outcome was 28-day mortality, and the secondary outcome was 7-day mortality. Restricted cubic splines (RCS) were utilized to visualize the relationship between APRI and 28-day mortality risk. The independent association between APRI and outcomes was assessed using Cox proportional hazards models, with multivariable analyses controlling for confounding factors. The predictive ability of APRI for outcomes was evaluated using receiver operating characteristic (ROC) curves.Results A total of 450 eligible patients were included, with 71 deaths occurring within 28 days. RCS analysis showed a positive correlation between APRI and 28-day mortality. Participants were divided into higher (APRI ≥ 15.14) and lower (APRI < 15.14) APRI groups. Cox proportional hazards models indicated that individuals with higher APRI had a significantly increased 28-day mortality rate (HR 5.322, 95% confidence interval [CI] 2.642-10.720, p < 0.0001). Subgroup and interaction analyses confirmed the robustness of the core findings. Additionally, the areas under the ROC (AUROC) for APRI predicting 28-day mortality was 0.823 (95% CI 0.772–0.875), significantly higher than the AST to ALT ratio (0.526, 95% CI 0.448–0.605) and total bilirubin (0.694, 95% CI 0.623–0.765).Conclusion APRI is an independent predictor of early mortality risk in heat stroke. |
| format | Article |
| id | doaj-art-2c6027aa3778410bacb3255dd1cfbdde |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-2c6027aa3778410bacb3255dd1cfbdde2025-08-20T03:22:15ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2478485Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective studyMin Wang0Yun Li1Yuan Cao2Meng-Meng Yang3Fu-Jing Liu4Jie Jiao5Sheng-Yuan Wang6Bin Song7Lu Wang8Yi-Qi Wu9Hong-Jun Kang10Medical School of Chinese PLA, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaDepartment of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Emergency, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Jiangsu, ChinaDepartment of Critical Care Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, ChinaThe Sixth Medical Centre, Chinese PLA General Hospital, Beijing, ChinaThe Seventh Medical Centre, Chinese PLA General Hospital, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaDepartment of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, ChinaBackground The aspartate aminotransferase-to-platelet ratio index (APRI) is an effective non-invasive marker for chronic liver dysfunction. Given that heat stroke patients often suffer from poor prognosis due to multi-organ involvement, with liver injury and coagulation dysfunction being of particular concern, this study aims to investigate whether APRI can comprehensively reflect liver injury and coagulation dysfunction in heat stroke patients and explore its relationship with 28-day mortality.Methods This retrospective study analysed electronic medical records from patients treated at 57 grade A tertiary hospitals in China from May 2005 to May 2024. The primary outcome was 28-day mortality, and the secondary outcome was 7-day mortality. Restricted cubic splines (RCS) were utilized to visualize the relationship between APRI and 28-day mortality risk. The independent association between APRI and outcomes was assessed using Cox proportional hazards models, with multivariable analyses controlling for confounding factors. The predictive ability of APRI for outcomes was evaluated using receiver operating characteristic (ROC) curves.Results A total of 450 eligible patients were included, with 71 deaths occurring within 28 days. RCS analysis showed a positive correlation between APRI and 28-day mortality. Participants were divided into higher (APRI ≥ 15.14) and lower (APRI < 15.14) APRI groups. Cox proportional hazards models indicated that individuals with higher APRI had a significantly increased 28-day mortality rate (HR 5.322, 95% confidence interval [CI] 2.642-10.720, p < 0.0001). Subgroup and interaction analyses confirmed the robustness of the core findings. Additionally, the areas under the ROC (AUROC) for APRI predicting 28-day mortality was 0.823 (95% CI 0.772–0.875), significantly higher than the AST to ALT ratio (0.526, 95% CI 0.448–0.605) and total bilirubin (0.694, 95% CI 0.623–0.765).Conclusion APRI is an independent predictor of early mortality risk in heat stroke.https://www.tandfonline.com/doi/10.1080/07853890.2025.2478485Heat strokeAPRIpredictormortality |
| spellingShingle | Min Wang Yun Li Yuan Cao Meng-Meng Yang Fu-Jing Liu Jie Jiao Sheng-Yuan Wang Bin Song Lu Wang Yi-Qi Wu Hong-Jun Kang Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study Annals of Medicine Heat stroke APRI predictor mortality |
| title | Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study |
| title_full | Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study |
| title_fullStr | Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study |
| title_full_unstemmed | Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study |
| title_short | Aspartate aminotransferase-to-platelet ratio index as a novel predictor of early mortality in heat stroke patients: a multi-centre retrospective study |
| title_sort | aspartate aminotransferase to platelet ratio index as a novel predictor of early mortality in heat stroke patients a multi centre retrospective study |
| topic | Heat stroke APRI predictor mortality |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2478485 |
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