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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
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]