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