1. Thrombocytopenia and platelet transfusions in ICU patients:an international inception cohort study (PLOT-ICU)
- Author
-
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, Dufranc, Etienne, Canet, Emmanuel, Lundqvist, Linda, Wright, Christopher John, Schmidt, Julien, Uhel, Fabrice, Ait-Oufella, Hafid, Krag, Mette, Cos Badia, Elisabet, Díaz-Lagares, Cándido, Menat, Sophie, Voiriot, Guillaume, Clausen, Niels Erikstrup, Lorentzen, Kristian, Kvåle, Reidar, Hildebrandt, Thomas, Holten, Aleksander Rygh, Strand, Kristian, Tzalavras, Asterios, Bestle, Morten Heiberg, Klepstad, Pål, Fernandez, Sara, Vimpere, Damien, Costa, Carolina, Graça, Carina, Lueck, Catherina, Juhl, Christian Svendsen, Bådstøløkken, Per Martin, Miranda, Teresa, Lêdo, Lia Susana Aires, Sousa Torres, Joao Carlos, Granholm, Anders, Møller, Morten Hylander, Russell, Lene, Khalil, Ahmed, Yehia, Ahmed, Salem, Haney, Farahat, Hesham, Sudevan, Manu, Biggart, Melissa, Fatima, Nirmeen, Elkhonezy, Mohammed, Bunzel, Anne Marie, Siegumfeldt, Rine M., Vestergaard, Stine R., Pelle, Juliette, Lê, Minh Pierre, Vigneron, Clara, Bertrix, Morgane, Cirera, Paul, Laghlam, Driss, Bredin, Swann, Marin, Nathalie, Toppenberg, Maria, Benelli, Brice, Seguin, Amélie, Garret, Charlotte, Guillotin, Florian, Blonz, Gauthier, Lascarrou, Jean Baptiste, Lemarie, Jérémie, Desmedt, Luc, Agbakou, Maïté, Carpentier, Mathieu, Martin, Maëlle, Benkalfate, Naïla, Zambon, Olivier, Decamps, Paul, Wilquin, Pauline L., Benguerfi, Soraya, Gardner, John, Remor, Natalie, Carr, Sheila, Yang, Gloria, Gernez, Coralie, Thiry, Ingrid, Missri, Louai, Denneborg, Moritz K.G., Brown, Katherine, Casares, Vanessa, Sivula, Mirka, Lappi, Elina, Pettilä, Leena, Heinonen, Jonna, Saario, Minttu, Mecheri, Manal K., Elabbadi, Alezandre, Desnos, Cyrielle, Lafarge, Antoine, Mghirbi, Olfa, Sjøbø, Brit, Christoffersen, Cecilie, Bestle, Frederik H., Lemos, Claudia, Gonçalves, Cristiana V., Jacinto, Nuno M.B., Anselmo, Monica P., Hoeper, Marius M., Hoff, Marja, Simões Freire, Pedro M., 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, Dufranc, Etienne, Canet, Emmanuel, Lundqvist, Linda, Wright, Christopher John, Schmidt, Julien, Uhel, Fabrice, Ait-Oufella, Hafid, Krag, Mette, Cos Badia, Elisabet, Díaz-Lagares, Cándido, Menat, Sophie, Voiriot, Guillaume, Clausen, Niels Erikstrup, Lorentzen, Kristian, Kvåle, Reidar, Hildebrandt, Thomas, Holten, Aleksander Rygh, Strand, Kristian, Tzalavras, Asterios, Bestle, Morten Heiberg, Klepstad, Pål, Fernandez, Sara, Vimpere, Damien, Costa, Carolina, Graça, Carina, Lueck, Catherina, Juhl, Christian Svendsen, Bådstøløkken, Per Martin, Miranda, Teresa, Lêdo, Lia Susana Aires, Sousa Torres, Joao Carlos, Granholm, Anders, Møller, Morten Hylander, Russell, Lene, Khalil, Ahmed, Yehia, Ahmed, Salem, Haney, Farahat, Hesham, Sudevan, Manu, Biggart, Melissa, Fatima, Nirmeen, Elkhonezy, Mohammed, Bunzel, Anne Marie, Siegumfeldt, Rine M., Vestergaard, Stine R., Pelle, Juliette, Lê, Minh Pierre, Vigneron, Clara, Bertrix, Morgane, Cirera, Paul, Laghlam, Driss, Bredin, Swann, Marin, Nathalie, Toppenberg, Maria, Benelli, Brice, Seguin, Amélie, Garret, Charlotte, Guillotin, Florian, Blonz, Gauthier, Lascarrou, Jean Baptiste, Lemarie, Jérémie, Desmedt, Luc, Agbakou, Maïté, Carpentier, Mathieu, Martin, Maëlle, Benkalfate, Naïla, Zambon, Olivier, Decamps, Paul, Wilquin, Pauline L., Benguerfi, Soraya, Gardner, John, Remor, Natalie, Carr, Sheila, Yang, Gloria, Gernez, Coralie, Thiry, Ingrid, Missri, Louai, Denneborg, Moritz K.G., Brown, Katherine, Casares, Vanessa, Sivula, Mirka, Lappi, Elina, Pettilä, Leena, Heinonen, Jonna, Saario, Minttu, Mecheri, Manal K., Elabbadi, Alezandre, Desnos, Cyrielle, Lafarge, Antoine, Mghirbi, Olfa, Sjøbø, Brit, Christoffersen, Cecilie, Bestle, Frederik H., Lemos, Claudia, Gonçalves, Cristiana V., Jacinto, Nuno M.B., Anselmo, Monica P., Hoeper, Marius M., Hoff, Marja, and Simões Freire, Pedro M.
- 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., 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.
- Published
- 2023