Assessment of thrombocytopenia in critically ill patients

Abstract

Background: Thrombocytopenia is commonly observed among critically ill patients. Aim: The aim of this study was to evaluate the incidence, risk factors, and the outcome of thrombocytopenia in patients admitted to the respiratory intensive care unit (RICU). Materials and methods: Data were collected from 50 adult patients admitted to the RICU in a 6-month period. The baseline platelet count was measured and was repeated every other day during the RICU stay period. Thrombocytopenia was defined as platelet count of less than 150´109/l. Results: The incidence of thrombocytopenia was 20% (10 patients). The overall mortality was 16%, of which 50% of the patients were having thrombocytopenia. The thrombocytopenic group had a higher mortality (40 vs. 10%, P < 0.05), a lower admission platelet count (215.3 ± 85.6 vs. 252.8 ± 73.2, P < 0.05), a lower nadir platelet count (111.1 ± 22.6 vs. 213.9 ± 53.2, P < 0.001), an increased transfusion requirement (30 vs. 2.5%, P < 0.05), and increased septic shock (40 vs. 2.5%, P < 0.05) compared with the nonthrombocytopenic group. Comorbidities, indications for RICU admission, the length of RICU stay, mechanical ventilation, days on mechanical ventilation, admission severity scores, bleeding, ICU-related complications, and medications administrated during the RICU stay did not differ significantly. A prolonged RICU stay of more than 15 days carried a 4.7 times higher incidence of development of thrombocytopenia. Thrombocytopenia differed significantly between survivors and nonsurvivors (P < 0.05), with a significant effect on mortality (P = 0.034). Conclusion: Thrombocytopenia is common among critically ill patients and affects the mortality significantly. Prolonged ICU stay and septic shock are among the risk factors for thrombocytopenia. Egypt J Broncho 8:143–148