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Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU).


ABSTRACT:

Purpose

Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients.

Methods

We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses.

Results

We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4-46.1) had thrombocytopenia; 23.4% (20-26) had thrombocytopenia at ICU admission, and 19.8% (17.6-22.2) developed thrombocytopenia during their ICU stay. Absence of acquired immune deficiency syndrome (AIDS), non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19-2.42).

Conclusion

Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.

SUBMITTER: Anthon CT 

PROVIDER: S-EPMC10622358 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU).

Anthon Carl Thomas CT   Pène Frédéric F   Perner Anders A   Azoulay Elie E   Puxty Kathryn K   Van De Louw Andry A   Barratt-Due Andreas A   Chawla Sanjay S   Castro Pedro P   Póvoa Pedro P   Coelho Luis L   Metaxa Victoria V   Kochanek Matthias M   Liebregts Tobias T   Kander Thomas T   Hästbacka Johanna J   Andreasen Jo Bønding JB   Péju Edwige E   Nielsen Lene Bjerregaard LB   Hvas Christine Lodberg CL   Dufranc Etienne E   Canet Emmanuel E   Lundqvist Linda L   Wright Christopher John CJ   Schmidt Julien J   Uhel Fabrice F   Ait-Oufella Hafid H   Krag Mette M   Cos Badia Elisabet E   Díaz-Lagares Cándido C   Menat Sophie S   Voiriot Guillaume G   Clausen Niels Erikstrup NE   Lorentzen Kristian K   Kvåle Reidar R   Hildebrandt Thomas T   Holten Aleksander Rygh AR   Strand Kristian K   Tzalavras Asterios A   Bestle Morten Heiberg MH   Klepstad Pål P   Fernandez Sara S   Vimpere Damien D   Paulino Carolina C   Graça Carina C   Lueck Catherina C   Juhl Christian Svendsen CS   Costa Carolina C   Bådstøløkken Per Martin PM   Miranda Teresa T   Lêdo Lia Susana Aires LSA   Sousa Torres Joao Carlos JC   Granholm Anders A   Møller Morten Hylander MH   Russell Lene L  

Intensive care medicine 20231009 11


<h4>Purpose</h4>Thrombocytopenia (platelet count < 150 × 10<sup>9</sup>/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients.<h4>Methods</h4>We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluate  ...[more]

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