Thrombocytopenia is common in ICU patients and some studies suggested a prognostic role in combination with other factors. Our study is designed to evaluate if platelet count could be used as a prognostic indicator of outcome in critically ill patients.
Retrospective chart review of randomly selected medical-surgical ICU patients over two years and stayed in ICU more than 48 hrs.Patients who had thrombocytopenia on admission, history of platelet dysfunction/hematological disorders/blood malignancies, history of splenectomy, recent radiation or chemotherapy or were on bone marrow-platelet suppressive agents were excluded from the study. Charts were reviewed for demographics, admission diagnoses, co-morbidities, platelet count, and multi-organ dysfunction score (MODS) & SOFA score on day of admission, day of nadir platelet count and on the last day in ICU. Patients were divided into two groups: thrombocytopenia group (TCP) with a platelet count below 150,000 at any time during their ICU stay and the normal group (NL) with count above 150,000. They were compared for survival, length of stay (LOS), MODS, SOFA score, transfusion requirements, number of days requiring mechanical ventilation (MV).
300 patients included with mean age 67 & 54% females. The overall mortality was 18% with 40% had TCP.TCP-group had higher mortality compared to NL-group (29% vs 10%, P < 0.0001), increased transfusion requirement(66% vs 46%, P = 0.0008), longer ventilator support (mean 6.6 vs 3.7 days, P = 0.0016), longer ICU-stay (mean 11.4 vs 7.6days, P < 0.0001), worse MODS and SOFA score on nadir platelet count and last day in ICU (P < 0.0001). MODS-score was not significantly different between the two groups at the time of admission (P = 0.09).
Thrombocytopenia is common in ICU and associated with increased risk of death, longer ICU stay, prolonged mechanical ventilation support, increased transfusion requirement, and development of organ dysfunction.
Platelet count can be used as a prognostic indicator of outcome in critically ill patients as development of thrombocytopenia is associated with increased mortality and morbidity.
Amitkumar Mehta, No Financial Disclosure Information; No Product/Research Disclosure Information