TY - JOUR
T1 - Thrombocytopenia and platelet transfusions in ICU patients
T2 - an international inception cohort study (PLOT-ICU)
AU - Anthon, Carl Thomas
AU - Pène, Frédéric
AU - Perner, Anders
AU - Azoulay, Elie
AU - Puxty, Kathryn
AU - Van De Louw, Andry
AU - Barratt-Due, Andreas
AU - Chawla, Sanjay
AU - Castro, Pedro
AU - Póvoa, Pedro
AU - Coelho, Luis
AU - Metaxa, Victoria
AU - Kochanek, Matthias
AU - Liebregts, Tobias
AU - Kander, Thomas
AU - Hästbacka, Johanna
AU - Andreasen, Jo Bønding
AU - Péju, Edwige
AU - Nielsen, Lene Bjerregaard
AU - Hvas, Christine Lodberg
AU - Dufranc, Etienne
AU - Canet, Emmanuel
AU - Lundqvist, Linda
AU - Wright, Christopher John
AU - Schmidt, Julien
AU - Uhel, Fabrice
AU - Ait-Oufella, Hafid
AU - Krag, Mette
AU - Cos Badia, Elisabet
AU - Díaz-Lagares, Cándido
AU - Menat, Sophie
AU - Voiriot, Guillaume
AU - Clausen, Niels Erikstrup
AU - Lorentzen, Kristian
AU - Kvåle, Reidar
AU - Hildebrandt, Thomas
AU - Holten, Aleksander Rygh
AU - Strand, Kristian
AU - Tzalavras, Asterios
AU - Bestle, Morten Heiberg
AU - Klepstad, Pål
AU - Fernandez, Sara
AU - Vimpere, Damien
AU - Paulino, Carolina
AU - Graça, Carina
AU - Lueck, Catherina
AU - Juhl, Christian Svendsen
AU - Costa, Carolina
AU - Bådstøløkken, Per Martin
AU - Miranda, Teresa
N1 - © 2023. The Author(s).
PY - 2023/11
Y1 - 2023/11
N2 - 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.
AB - 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.
KW - Bleeding
KW - Critical illness
KW - Intensive care unit
KW - Platelet transfusion
KW - Thrombocytopenia
KW - Thrombosis
U2 - 10.1007/s00134-023-07225-2
DO - 10.1007/s00134-023-07225-2
M3 - Article
C2 - 37812225
SN - 0342-4642
VL - 49
SP - 1327
EP - 1338
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 11
ER -