Prevalence, causes and outcomes of thrombocytopenia among patients in medical intensive care units
Keywords:thrombocytopenia, intensive care unit, platelet, medical intensive care unit
Objective: The study aimed to identify the prevalence, causes, outcomes and prognostic factors for survival of patients with thrombocytopenia in a medical ICU. Material and Methods: This comprised a retrospective study conducted at Maharaj Nakorn Chiang Mai Hospital. Data were collated from adult patients admitted to a medical ICU with a platelet count ≤ 100 x109/L from January 2016 to December 2019. Clinical characteristics, outcomes and data were analyzed to investigate the prognostic factors for survival. Results: Of 2,039 patients admitted to a medical ICU, thrombocytopenia was prevalent in 182 cases (8.9%). The most common cause of thrombocytopenia was infections (85%). Mean platelet count during the thrombocytopenic period and platelet nadir were
55.8±27.9 x109/L and 34.6±26.5 x109/L, respectively. Mean duration of thrombocytopenia was 11.9+4.1 days, and rate of bleeding complications and mortality were 30.7% and 67.0%, respectively. Survival analysis revealed that age ≥ 80 years (HR 1.99; 95%CI: 1.16-3.39, p = 0.012) and low nadir hemoglobin (Hb) (HR 0.88; 95%CI: 0.81-0.97, p = 0.01) were the variables significantly associated with increased mortality. Conclusion: The prevalence of thrombocytopenia in a medical ICU was 8.9% with a mortality of 67.0%. Infection was the most common cause. Age ≥ 80 years and low nadir Hb were associated with higher mortality rate.
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