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.
Original language | English |
---|---|
Journal | Intensive Care Medicine |
Volume | 49 |
Issue number | 11 |
Pages (from-to) | 1327-1338 |
Number of pages | 12 |
ISSN | 0342-4642 |
DOIs | |
Publication status | Published - 2023 |
Bibliographical note
Correction: DOI 10.1007/s00134-023-07291-6Publisher Copyright:
© 2023, The Author(s).
Keywords
- Bleeding
- Critical illness
- Intensive care unit
- Platelet transfusion
- Thrombocytopenia
- Thrombosis
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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; Costa, 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; 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.
In: Intensive Care Medicine, Vol. 49, No. 11, 2023, p. 1327-1338.Research output: Contribution to journal › Journal article › Research › peer-review
}
TY - JOUR
T1 - Thrombocytopenia and platelet transfusions in ICU patients
T2 - an international inception cohort study (PLOT-ICU)
AU - Anthon, Carl Thomas
AU - Pène, Frédéric
AU - Perner, Anders
AU - Azoulay, Elie
AU - Puxty, Kathryn
AU - Van De Louw, Andry
AU - Barratt-Due, Andreas
AU - Chawla, Sanjay
AU - Castro, Pedro
AU - Póvoa, Pedro
AU - Coelho, Luis
AU - Metaxa, Victoria
AU - Kochanek, Matthias
AU - Liebregts, Tobias
AU - Kander, Thomas
AU - Hästbacka, Johanna
AU - Andreasen, Jo Bønding
AU - Péju, Edwige
AU - Nielsen, Lene Bjerregaard
AU - Hvas, Christine Lodberg
AU - Dufranc, Etienne
AU - Canet, Emmanuel
AU - Lundqvist, Linda
AU - Wright, Christopher John
AU - Schmidt, Julien
AU - Uhel, Fabrice
AU - Ait-Oufella, Hafid
AU - Krag, Mette
AU - Cos Badia, Elisabet
AU - Díaz-Lagares, Cándido
AU - Menat, Sophie
AU - Voiriot, Guillaume
AU - Clausen, Niels Erikstrup
AU - Lorentzen, Kristian
AU - Kvåle, Reidar
AU - Hildebrandt, Thomas
AU - Holten, Aleksander Rygh
AU - Strand, Kristian
AU - Tzalavras, Asterios
AU - Bestle, Morten Heiberg
AU - Klepstad, Pål
AU - Fernandez, Sara
AU - Vimpere, Damien
AU - Costa, Carolina
AU - Graça, Carina
AU - Lueck, Catherina
AU - Juhl, Christian Svendsen
AU - Costa, Carolina
AU - Bådstøløkken, Per Martin
AU - Miranda, Teresa
AU - Lêdo, Lia Susana Aires
AU - Sousa Torres, Joao Carlos
AU - Granholm, Anders
AU - Møller, Morten Hylander
AU - Russell, Lene
AU - Khalil, Ahmed
AU - Yehia, Ahmed
AU - Salem, Haney
AU - Farahat, Hesham
AU - Sudevan, Manu
AU - Biggart, Melissa
AU - Fatima, Nirmeen
AU - Elkhonezy, Mohammed
AU - Bunzel, Anne Marie
AU - Siegumfeldt, Rine M.
AU - Vestergaard, Stine R.
AU - Pelle, Juliette
AU - Lê, Minh Pierre
AU - Vigneron, Clara
AU - Bertrix, Morgane
AU - Cirera, Paul
AU - Laghlam, Driss
AU - Bredin, Swann
AU - Marin, Nathalie
AU - Toppenberg, Maria
AU - Benelli, Brice
AU - Seguin, Amélie
AU - Garret, Charlotte
AU - Guillotin, Florian
AU - Blonz, Gauthier
AU - Lascarrou, Jean Baptiste
AU - Lemarie, Jérémie
AU - Desmedt, Luc
AU - Agbakou, Maïté
AU - Carpentier, Mathieu
AU - Martin, Maëlle
AU - Benkalfate, Naïla
AU - Zambon, Olivier
AU - Decamps, Paul
AU - Wilquin, Pauline L.
AU - Benguerfi, Soraya
AU - Gardner, John
AU - Remor, Natalie
AU - Carr, Sheila
AU - Yang, Gloria
AU - Gernez, Coralie
AU - Thiry, Ingrid
AU - Missri, Louai
AU - Denneborg, Moritz K.G.
AU - Brown, Katherine
AU - Casares, Vanessa
AU - Sivula, Mirka
AU - Lappi, Elina
AU - Pettilä, Leena
AU - Heinonen, Jonna
AU - Saario, Minttu
AU - Mecheri, Manal K.
AU - Elabbadi, Alezandre
AU - Desnos, Cyrielle
AU - Lafarge, Antoine
AU - Mghirbi, Olfa
AU - Sjøbø, Brit
AU - Christoffersen, Cecilie
AU - Bestle, Frederik H.
AU - Lemos, Claudia
AU - Gonçalves, Cristiana V.
AU - Jacinto, Nuno M.B.
AU - Anselmo, Monica P.
AU - Hoeper, Marius M.
AU - Hoff, Marja
AU - Simões Freire, Pedro M.
N1 - Correction: DOI 10.1007/s00134-023-07291-6 Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - Bleeding
KW - Critical illness
KW - Intensive care unit
KW - Platelet transfusion
KW - Thrombocytopenia
KW - Thrombosis
U2 - 10.1007/s00134-023-07225-2
DO - 10.1007/s00134-023-07225-2
M3 - Journal article
C2 - 37812225
AN - SCOPUS:85173919249
VL - 49
SP - 1327
EP - 1338
JO - European Journal of Intensive Care Medicine
JF - European Journal of Intensive Care Medicine
SN - 0935-1701
IS - 11
ER -