We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU).
- Authors
Anthon, Carl Thomas; Pène, Frédéric; Perner, Anders; Azoulay, Elie; Puxty, Kathryn; Van De Louw, Andry; Barratt-Due, Andreas; Chawla, Sanjay; Castro, Pedro; Póvoa, Pedro; Coelho, Luis; Metaxa, Victoria; Kochanek, Matthias; Liebregts, Tobias; Kander, Thomas; Hästbacka, Johanna; Andreasen, Jo Bønding; Péju, Edwige; Nielsen, Lene Bjerregaard; Hvas, Christine Lodberg
- 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.
- Subjects
BLOOD platelet transfusion; AIDS; BLOOD transfusion; THROMBOCYTOPENIA; COHORT analysis
- Publication
Intensive Care Medicine, 2023, Vol 49, Issue 11, p1327
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-023-07225-2