Thrombocytopenia is associated with mortality in hospitalized patients with low risk of death

Introduction

Thrombocytopenia is inversely related to survival in critical care patients [1]. The objective of the present study was to evaluate the prevalence of thrombocytopenia in patients of an ICU and to determine whether it might be a significant predictor of outcome.

Methods

A prospective observational cohort study was performed from April to September 2007 in a 24-bed medical–surgical ICU. All patients admitted to the ICU during the period of observation were included in the study. Patients were prospectively studied until 14 days from admission, discharge from the ICU, or death. Patients who had thrombocytopenia on admission or spent less than 48 hours in the ICU were excluded from the patient population.

Results

During the period of observation, 215 patients were admitted to the ICU (57.5% male), with a median age 65.0 years (IQR 54–77) and APACHE II score 14.0 (IQR 10.0–19.0). One hundred and seventy-six subjects (81.9%) were alive after a 14-day follow-up. Seventy patients (32.6%) developed thrombocytopenia during the study. Patients who ever developed thrombocytopenia had a higher ICU mortality (28.6% vs 13.0%, respectively; P < 0.006) and a higher consumption of blood products (24% vs 2%, P < 0.0001). However, both groups had the same APACHE II score (15.15 ± 6.1 vs 15.15 ± 7.2, P = 0.99) and ICU stay (8.2 ± 7.1 vs 8.4 ± 12.8, P = 0.93).

Conclusion

Even in an ICU sample with a low risk of death predicted by the APACHE II score, thrombocytopenia was highly associated with higher mortality and consumption of blood products.