Thrombocytopenia and platelet transfusions in ICU patients : an international inception cohort study (PLOT-ICU)
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; Paulino, Carolina; Graça, Carina; Lueck, Catherina; Juhl, Christian Svendsen; Costa, Carolina; Bådstøløkken, Per Martin; Miranda, Teresa; Lêdo, Lia Susana Aires; Sousa Torres, Joao Carlos; Granholm, Anders; Møller, Morten Hylander; Russell, Lene (2023)
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
Paulino, Carolina
Graça, Carina
Lueck, Catherina
Juhl, Christian Svendsen
Costa, Carolina
Bådstøløkken, Per Martin
Miranda, Teresa
Lêdo, Lia Susana Aires
Sousa Torres, Joao Carlos
Granholm, Anders
Møller, Morten Hylander
Russell, Lene
2023
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-2023112010095
https://urn.fi/URN:NBN:fi:tuni-2023112010095
Kuvaus
Peer reviewed
Tiivistelmä
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.
Kokoelmat
- TUNICRIS-julkaisut [17066]