Journal Articles Intensive Care Medicine Year : 2023

Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Carl Thomas Anthon (1) , Frédéric Pène (2) , Anders Perner (1, 3, 4) , Elie Azoulay (4, 5) , Kathryn Puxty (6) , Andry van de Louw (7) , Andreas Barratt-Due (8) , Sanjay Chawla (9, 10) , Pedro Castro (11) , Pedro Póvoa (12, 13) , Luis Coelho (13) , Victoria Metaxa (14) , Matthias Kochanek (15) , Tobias Liebregts (16) , Thomas Kander (17, 18) , Johanna Hästbacka (19, 20, 21, 22) , Jo Bønding Andreasen (23) , Edwige Péju (2) , Lene Bjerregaard Nielsen (12) , Christine Lodberg Hvas (24) , Etienne Dufranc (25) , Emmanuel Canet (26, 27) , Linda Lundqvist (18) , Christopher John Wright (28) , Julien Schmidt , Fabrice Uhel , Hafid Ait-Oufella , Mette Krag , Elisabet Cos Badia , Cándido Díaz-Lagares , Sophie Menat , Guillaume Voiriot (29) , Niels Erikstrup Clausen , Kristian Lorentzen , Reidar Kvåle , Thomas Hildebrandt , Aleksander Rygh Holten , Kristian Strand , Asterios Tzalavras , Morten Heiberg Bestle , Pål Klepstad , Sara Fernandez , Damien Vimpere , Carolina Paulino , Carina Graça , Catherina Lueck , Christian Svendsen Juhl , Carolina Costa , Per Martin Bådstøløkken , Teresa Miranda , Lia Susana Aires Lêdo , Joao Carlos Sousa Torres , Anders Granholm , Morten Hylander Møller , Lene Russell , Ahmed Khalil , Ahmed Yehia , Haney Salem , Hesham Farahat , Manu Sudevan , Melissa Biggart , Nirmeen Fatima , Mohammed Elkhonezy , Anne-Marie Bunzel , Rine M Siegumfeldt , Stine R Vestergaard , Juliette Pelle , Minh-Pierre Lê , Clara Vigneron , Morgane Bertrix , Paul Cirera , Driss Laghlam , Swann Bredin , Nathalie Marin , Maria Toppenberg , Brice Benelli , Amélie Seguin , Charlotte Garret , Florian Guillotin , Gauthier Blonz , Jean-Baptiste Lascarrou , Jérémie Lemarie , Luc Desmedt , Maïté Agbakou , Mathieu Carpentier , Maëlle Martin , Naïla Benkalfate , Olivier Zambon , Paul Decamps , Pauline L Wilquin , Soraya Benguerfi , John Gardner , Natalie Remor , Sheila Carr , Gloria Yang , Coralie Gernez , Ingrid Thiry , Louai Missri , Moritz K G Denneborg , Katherine Brown , Vanessa Casares , Mirka Sivula , Elina Lappi , Leena Pettilä , Jonna Heinonen , Minttu Saario , Manal K Mecheri , Alezandre Elabbadi , Cyrielle Desnos , Antoine Lafarge , Olfa Mghirbi , Brit Å Sjøbø , Cecilie Christoffersen , Frederik H Bestle , Claudia Lemos , Cristiana V Gonçalves , Nuno M B Jacinto , Monica P Anselmo , Marius M Hoeper , Marja Hoff , Pedro M Simões Freire , Frédéric Pène
1 KUH - Copenhagen University Hospital [Denmark] = Københavns Universitetshospital [Danmark]
2 IC UM3 (UMR 8104 / U1016) - Institut Cochin
3 UCPH - Københavns Universitet = University of Copenhagen = Université de Copenhague
4 AP-HP - Hopital Saint-Louis [AP-HP]
5 UPCité - Université Paris Cité
6 Glasgow Royal Infirmary
7 Penn State - Pennsylvania State University [State College, PA]
8 Oslo University Hospital [Oslo]
9 MSKCC - Memorial Sloan Kettering Cancer Center
10 Weill Medical College of Cornell University [New York]
11 UAB - Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona
12 OUH - Odense University Hospital
13 NMS - NOVA Medical School - Faculdade de Ciências Médicas
14 KCH - King's College Hospital
15 Universität zu Köln = University of Cologne
16 Universität Duisburg-Essen = University of Duisburg-Essen [Essen]
17 Lund University
18 Skane University Hospital [Lund]
19 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
20 HUS - Helsinki University Hospital [Finland]
21 Tampere University Hospital
22 University of Tampere [Finland]
23 AAU - Aalborg University
24 Aarhus University Hospital
25 CHU Henri Mondor [Créteil]
26 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
27 Nantes Univ - UFR MEDECINE - Nantes Université - UFR de Médecine et des Techniques Médicales
28 Queen Elizabeth University Hospital (Glasgow)
29 CRSA - Centre de Recherche Saint-Antoine
Julien Schmidt
  • Function : Author
Fabrice Uhel
  • Function : Author
Hafid Ait-Oufella
Mette Krag
  • Function : Author
Elisabet Cos Badia
  • Function : Author
Cándido Díaz-Lagares
  • Function : Author
Sophie Menat
  • Function : Author
Niels Erikstrup Clausen
  • Function : Author
Kristian Lorentzen
  • Function : Author
Reidar Kvåle
  • Function : Author
Thomas Hildebrandt
  • Function : Author
Aleksander Rygh Holten
  • Function : Author
Kristian Strand
  • Function : Author
Asterios Tzalavras
  • Function : Author
Morten Heiberg Bestle
  • Function : Author
Pål Klepstad
  • Function : Author
Sara Fernandez
  • Function : Author
Damien Vimpere
  • Function : Author
Carolina Paulino
  • Function : Author
Carina Graça
  • Function : Author
Catherina Lueck
  • Function : Author
Christian Svendsen Juhl
  • Function : Author
Carolina Costa
  • Function : Author
Per Martin Bådstøløkken
  • Function : Author
Teresa Miranda
  • Function : Author
Lia Susana Aires Lêdo
  • Function : Author
Joao Carlos Sousa Torres
  • Function : Author
Anders Granholm
  • Function : Author
Morten Hylander Møller
  • Function : Author
Lene Russell
  • Function : Author
Ahmed Khalil
  • Function : Author
Ahmed Yehia
  • Function : Author
Haney Salem
  • Function : Author
Hesham Farahat
  • Function : Author
Manu Sudevan
  • Function : Author
Melissa Biggart
  • Function : Author
Nirmeen Fatima
  • Function : Author
Mohammed Elkhonezy
  • Function : Author
Anne-Marie Bunzel
  • Function : Author
Rine M Siegumfeldt
  • Function : Author
Stine R Vestergaard
  • Function : Author
Juliette Pelle
  • Function : Author
Minh-Pierre Lê
  • Function : Author
Clara Vigneron
  • Function : Author
Morgane Bertrix
  • Function : Author
Paul Cirera
  • Function : Author
Driss Laghlam
  • Function : Author
Swann Bredin
  • Function : Author
Nathalie Marin
  • Function : Author
Maria Toppenberg
  • Function : Author
Brice Benelli
  • Function : Author
Amélie Seguin
  • Function : Author
Charlotte Garret
  • Function : Author
Florian Guillotin
  • Function : Author
Gauthier Blonz
  • Function : Author
Jean-Baptiste Lascarrou
Jérémie Lemarie
  • Function : Author
Luc Desmedt
  • Function : Author
Maïté Agbakou
  • Function : Author
Mathieu Carpentier
  • Function : Author
Maëlle Martin
  • Function : Author
Naïla Benkalfate
  • Function : Author
Olivier Zambon
  • Function : Author
Paul Decamps
  • Function : Author
Pauline L Wilquin
  • Function : Author
Soraya Benguerfi
  • Function : Author
John Gardner
  • Function : Author
Natalie Remor
  • Function : Author
Sheila Carr
  • Function : Author
Gloria Yang
  • Function : Author
Coralie Gernez
  • Function : Author
Ingrid Thiry
  • Function : Author
Louai Missri
  • Function : Author
Moritz K G Denneborg
  • Function : Author
Katherine Brown
  • Function : Author
Vanessa Casares
  • Function : Author
Mirka Sivula
  • Function : Author
Elina Lappi
  • Function : Author
Leena Pettilä
  • Function : Author
Jonna Heinonen
  • Function : Author
Minttu Saario
  • Function : Author
Manal K Mecheri
  • Function : Author
Alezandre Elabbadi
  • Function : Author
Cyrielle Desnos
  • Function : Author
Antoine Lafarge
  • Function : Author
Olfa Mghirbi
  • Function : Author
Brit Å Sjøbø
  • Function : Author
Cecilie Christoffersen
  • Function : Author
Frederik H Bestle
  • Function : Author
Claudia Lemos
  • Function : Author
Cristiana V Gonçalves
  • Function : Author
Nuno M B Jacinto
  • Function : Author
Monica P Anselmo
  • Function : Author
Marius M Hoeper
  • Function : Author
Marja Hoff
  • Function : Author
Pedro M Simões Freire
  • Function : Author
Frédéric Pène

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. CORRECTION PUBLISHED ON 2023-10-09 : https://doi.org/10.1007/s00134-023-07291-6

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hal-04840088 , version 1 (16-12-2024)

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Carl Thomas Anthon, Frédéric Pène, Anders Perner, Elie Azoulay, Kathryn Puxty, et al.. Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU). Intensive Care Medicine, 2023, 49 (11), ⟨10.1007/s00134-023-07225-2⟩. ⟨hal-04840088⟩
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