Author(s):
Anthon, Carl Thomas ; Pène, Frédéric ; Perner, Anders ; Azoulay, Elie ; Puxty, Kathryn ; Van De Louw, Andry ; Barratt-Due, Andreas ; Chawla, Sanjay ; Castro, Pedro ; Povoa, Pedro ; Coelho, Luis ; Metaxa, Victoria ; Kochanek, Matthias ; Liebregts, Tobias ; Kander, Thomas ; Hästbacka, Johanna ; Andreasen, Jo Bønding ; Péju, Edwige ; Nielsen, Lene Bjerregaard ; Hvas, Christine Lodberg ; Dufranc, Etienne ; Canet, Emmanuel ; Lundqvist, Linda ; Wright, Christopher John ; Schmidt, Julien ; Uhel, Fabrice ; Ait-Oufella, Hafid ; Krag, Mette ; Cos Badia, Elisabet ; Díaz-Lagares, Cándido ; Menat, Sophie ; Voiriot, Guillaume ; Clausen, Niels Erikstrup ; Lorentzen, Kristian ; Kvåle, Reidar ; Hildebrandt, Thomas ; Holten, Aleksander Rygh ; Strand, Kristian ; Tzalavras, Asterios ; Bestle, Morten Heiberg ; Klepstad, Pål ; Fernandez, Sara ; Vimpere, Damien ; Paulino, Carolina ; Graça, Carina ; Lueck, Catherina ; Juhl, Christian Svendsen ; Costa, Carolina ; Bådstøløkken, Per Martin ; Miranda, Teresa
Date: 2023
Persistent ID: http://hdl.handle.net/10362/160035
Origin: Repositório Institucional da UNL
Subject(s): Bleeding; Critical illness; Intensive care unit; Platelet transfusion; Thrombocytopenia; Thrombosis; SDG 3 - Good Health and Well-being
Description
© 2023. The Author(s).
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.
