Thrombocytopenia in Critical Care Unit: Risk Factors, Etiologies, and Management

Abstract

Introduction: Thrombocytopenia is a platelet count below 150,000/mm3. It is a frequent abnormality in critically ill patients. Methods: We conducted a retrospective study which included 603 patients admitted to the medical intensive care unit in the Ibn Rochd university hospital of Casablanca over a two years period, from January 1, 2018 to December 31, 2019. The aim of the study is to point out the incidence, risk factors, etiologies, therapeutic modalities, as well as the morbidity and mortality related to thrombocytopenia in critical care. Results: During the study period, and out of these 603 patients, 168 patients had thrombocytopenia, that is an incidence of 27.8%; 38 patients among them were admitted with an already ongoing thrombocytopenia. Sepsis, Acute respiratory distress syndrome, renal failure, hemodialysis, and liver dysfunction were risk factors of thrombocytopenia and predictors of mortality. Thrombocytopenia was a factor of increased mortality, the percentage of death was higher in the thrombocytopenic group compared with the non-thrombocytopenic group with a rate of 42.26%. However, it was not an independent factor of mortality. Conclusion: Sepsis is the major factor incriminated in the occurrence of thrombocytopenia in critically ill patients. Therapeutic management including platelet transfusion should depend on the etiology of thrombocytopenia along with the associated hemorrhagic risk.