Thrombocytopenia and platelet transfusions in ICU patients: An international inception cohort study (PLOT-ICU) Journal Article
| Authors: | Anthon, C. T.; Pène, F.; Perner, A.; Azoulay, E.; Puxty, K.; Van De Louw, A.; Barratt-Due, A.; Chawla, S.; Castro, P.; Póvoa, P.; Coelho, L.; Metaxa, V.; Kochanek, M.; Liebregts, T.; Kander, T.; Hästbacka, J.; Andreasen, J. B.; Péju, E.; Nielsen, L. B.; Hvas, C. L.; Dufranc, E.; Canet, E.; Lundqvist, L.; Wright, C. J.; Schmidt, J.; Uhel, F.; Ait-Oufella, H.; Krag, M.; Cos Badia, E.; Díaz-Lagares, C.; Menat, S.; Voiriot, G.; Clausen, N. E.; Lorentzen, K.; Kvåle, R.; Hildebrandt, T.; Holten, A. R.; Strand, K.; Tzalavras, A.; Bestle, M. H.; Klepstad, P.; Fernandez, S.; Vimpere, D.; Paulino, C.; Graça, C.; Lueck, C.; Juhl, C. S.; Costa, C.; Bådstøløkken, P. M.; Miranda, T.; Lêdo, L. S. A.; Sousa Torres, J. C.; Granholm, A.; Møller, M. H.; Russell, L.; on behalf of the PLOT-ICU Collaborators and the Nine-I Study Group |
| Contributors: | Remor, N.; Carr, S.; Yang, G. |
| Article Title: | Thrombocytopenia and platelet transfusions in ICU patients: An international inception cohort study (PLOT-ICU) |
| 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. © 2023, The Author(s). |
| Keywords: | adult; controlled study; aged; middle aged; retrospective studies; major clinical study; mortality; chemotherapy; prospective study; prospective studies; cohort studies; bleeding; thrombocytopenia; cohort analysis; hematopoietic stem cell transplantation; retrospective study; risk factor; risk assessment; liver failure; intensive care unit; intensive care units; thrombosis; hospital admission; immune deficiency; antithrombocytic agent; thrombocyte transfusion; hypertensive factor; anticoagulant agent; critical illness; critically ill patient; clinical outcome; septic shock; hemorrhage; platelet transfusion; humans; human; male; female; article; invasive ventilation |
| Journal Title: | Intensive Care Medicine |
| Volume: | 49 |
| Issue: | 11 |
| ISSN: | 0342-4642 |
| Publisher: | Springer Verlag |
| Date Published: | 2023-11-01 |
| Start Page: | 1327 |
| End Page: | 1338 |
| Language: | English |
| DOI: | 10.1007/s00134-023-07225-2 |
| PUBMED: | 37812225 |
| PROVIDER: | scopus |
| PMCID: | PMC10622358 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Erratum published at DOI: 10.1007/s00134-023-07291-6 -- Source: Scopus |
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