To determine the incidence, risk factors and outcome of patients with thrombocytopenia admitted to Makassed General Hospital ICU Community Hospital ICU in Lebanon.
A retrospective study of 103 medical and surgical patients admitted to a 6-bed ICU in a 200-bed community hospital from January 1 to June 30, 2000.
Thrombocytopenia (platelet count < 100,000/mm3) occurred in 21 patients (20.4%). In multivariate analysis, female gender, sepsis, shock, transfusion requirements, duration of stay, and APACHE II score of > 20 were found to be independent risk factors for the development of thrombocytopenia. Thrombocytopenic patients had a significantly higher mortality rate when compared to nonthrombocytopenic patients (52.4% vs. 25.6%, p = 0.018). Highest mortality (80%) was observed when thrombocytopenia and DIC coexisted. Interestingly, none of the patients with corrected platelet count died.
Thrombocytopenia in ICU patients is associated with higher mortality particularly in the setting of DIC. This probably reflects the severity of the overall clinical status and the underlying disease. Its correction seems to improve prognosis.
Thrombocytopenia is an alarming sign for the intensivists to be aware of, because such patients have a high mortality. Aggressive attempts to correct thrombocytopenia may alter the patient’s outcome.
Ali Debek, None.