Time course of platelet counts in critically ill patients

Akça, Serdar; Haji-Michael, Philip; Mendonça, Arnaldo de; Suter, Peter M.; Levi, Marcel; Vincent, Jean‐Louis

doi:10.1097/00003246-200204000-00005

Cited by 355 publications

(308 citation statements)

References 22 publications

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“…As an indicator of hematological system failure, thrombocytopenia reflects an increase in the mortality rate and severity of sepsis; therefore, it is included in the Sepsis-related Organ Failure Assessment (SOFA) score [2]. A limited number of studies have evaluated the relationship between sepsis and reduction in platelet count despite the fact that thrombocytopenia is equally as important as circulatory failure [3,4].…”

Section: Introductionmentioning

confidence: 99%

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Burunsuzoglu¹,

Saltürk²,

Karakurt³

et al. 2016

Turk Toraks Dergisi

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OBJECTIVES:The objective of this study was to evaluate the intensive care unit (ICU) and long-term mortality in sepsis patients with/ without thrombocytopenia on the fifth day of ICU admission. MATERIALS AND METHODS:The retrospective observational cohort study was performed in a teaching hospital, and patients with sepsis who stayed more than 4 days in the ICU between January 2012 and December 2012 were included. Patients were divided into two groups according to thier platelet count at fifth day of ICU stay: Group 1, < 150.000/μL; Group 2, >150.000/μL. Patients having thrombocytopenia on admission were excluded. The patients' characteristics, comorbid diseases, body mass index, arterial blood gas analysis and blood biochemistry results, SIRS criteria, Acute Physiological and Chronic Health Evaluation Score II (APACHE II), implication of invasive and non-invasive mechanical ventilation, use of sedation, nutrition information, and culture results of microbiological samples were recorded. The groups were compared according to the recorded data. Logistic regression analysis was performed for ICU mortality; the Kaplan-Meier test was used to evaluate 12-month survival after ICU discharge. RESULTS:During the period, 1003 patients were admitted to the ICU; 307 sepsis patients were included in the study. Group 1 (n= 67) and Group 2 (n=240) had similar patient characteristics and sepsis findings. The groups had similar ICU and hospital stays; mortality was higher in Group 1 than in Group 2 (40.3% vs. 17.5%, respectively, p< 0.001). Fifth day thrombocytopenia, septic shock, male gender, and low albumin levels were found to be risk factors of ICU mortality; the respective odds ratios, 95% confidence intervals, and p values for these factors were 3.03, [1.15-7.45 CONCLUSION:Higher rates of septic shock and mortality were seen in sepsis patients with thrombocytopenia in the ICU. The measurement of thrombocytopenia in the ICU, which is easy and low-cost, may help to predict mortality. Thus, precautions can be taken early in patient treatment and follow-up. As we know, early intervention is crucial in the approach to sepsis.

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Section: Introductionmentioning

confidence: 99%

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Burunsuzoglu¹,

Saltürk²,

Karakurt³

et al. 2016

Turk Toraks Dergisi

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“…Yoğun bakım hastaları üzerinde yapılmış çalışmalarda trombositopeni insidansı %13'den %44'e kadar çok geniş aralıkta bulunmuştur (4,(7)(8)(9)(10)(11)(12)(13)(14)(15). Yaptığımız çalışmada ise, MYBÜ'de takip edilen hastalarda girişte tüm hastaların %16'sı ve yoğun bakımda takip edilmiş hastaların %44,7'sinde trombositopeni geliştiği tespit edildi.…”

Section: Discussionunclassified

Incidence of Thrombocytopenia in Patients Hospitalized in the Intensive Care Unit and Factors Affecting the Development of Thrombocytopenia

Coşkun¹,

Mendil²,

Kaya³

et al. 2016

Yoğun Bakim Derg

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GirişTrombositopeni için farklı tanımlamalar olmakla beraber tam kan sayımındaki trombosit sayısının 150.000/μL altında olması trombositopeni olarak kabul edilir (1). Ancak bazı yazarlar tarafından trombositopeni sınırı 100.000/μL olarak kabul edilmektedir (2, 3). Trombositopenisi olan hastalarda beklenen en önemli problem kanamadır. Kanama riski trombosit değerleri ile ters orantılıdır (1).Objective: Thrombocytopenia is common in intensive care units (ICUs) and is associated with high mortality. The aim of this study was to determine the incidence of thrombocytopenia and to evaluate the factors affecting the development of thrombocytopenia in patients who stayed at a medical intensive care unit (MICU). Material and Methods:This study was conducted retrospectively in a MICU. The data were obtained from patients' folders and the hospital's electronic records system. Patients who stayed for more than 24 h in the ICU were included in the study. The demographic data, the worst laboratory values in the first 24 h, the lowest platelet counts, and medications that can cause thrombocytopenia were recorded.Results: A total of 237 patients were included in this study; 106 of them (45%) were female and 131 (55%) were male. Their average age was 62±18 years. The most common reasons for hospitalization in the ICU were respiratory failure (33%) and neurological diseases (13%). During follow-up, 45% of the patients developed thrombocytopenia. The mean APACHE-II score was 24±10 and SOFA score was 9±4. The mean MODS score was 6±3, and it was higher in the patients who developed thrombocytopenia than those who did not (p<0.0001). Upon analyzing the factors affecting the development of thrombocytopenia, prophylactic or therapeutic heparin use was determined in 61% of the patients. It was determined that 106 patients (45%) were using one or more drugs that can trigger thrombocytopenia. The patients who developed thrombocytopenia stayed longer in the ICU (p=0.042), and their overall mortality rate was higher than those who did not develop thrombocytopenia (91% vs. 55%; p<0.0001). Bulgular: Çalışmaya 237 hasta dâhil edildi. Hastaların 106'sı kadın (%45), 131'i ise erkekti (%55). Yaş ortalaması 62±18 yıl idi. En sık yoğun bakıma yatış nedenleri; solunum yetmezliği (%33) ve nörolojik hastalıklar (%13) idi. Takiplerinde hastaların %45'inde trombositopeni gelişti. Hastaların ortalama APACHE II skoru 24±10, SOFA skoru 9±4 ve MODS skoru 6±3 idi ve trombositopeni gelişen hastalarda gelişmeyenlere göre daha yüksek bulundu (p<0,0001). Trombositopeni gelişimini etkileyen faktörler incelendiğinde hastaların %61'inin profilaktik veya tedavi dozunda heparin aldığı tespit edildi. Hastaların 106'sında (%45) ise bir veya daha fazla trombositopeni yapan ilaç kullanıldığı görüldü. Trombositopeni gelişen hastalarda yoğun bakımda kalma süresi daha uzun idi (p=0,042). Hastaların genel mortalitesi trombositopeni gelişenlerde gelişmeyenlere göre daha yüksek idi (%91 ve %55; p<0,0001).

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“…Increasing thrombocytopenia was associated with higher mortality and longer length of hospital stay, and the increase of the platelet count was an early sign of clinical improvement [2][3][4][6][7][8][9][10] Contrary to this concept, microthrombogenesis plays a key role in the pathogenesis of TTP and TTP-like syndrome. In endotheliopathy, the platelet is activated and excessive amounts of ULVWF are released from ECs [24][25][26][27]40].…”

Section: Tcip In the Critical Care Settingmentioning

confidence: 99%

Thrombocytopenia in critically ill patients due to vascular microthrombotic disease: pathogenesis based on “two activation theory of the endothelium”

Chang¹

2017

Vascul Dis Ther

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Time course of platelet counts in critically ill patients

Cited by 355 publications

References 22 publications

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Incidence of Thrombocytopenia in Patients Hospitalized in the Intensive Care Unit and Factors Affecting the Development of Thrombocytopenia

Thrombocytopenia in critically ill patients due to vascular microthrombotic disease: pathogenesis based on “two activation theory of the endothelium”

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