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Open Access 09-10-2023 | Thrombocytopenia | Original

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

Authors: Carl Thomas Anthon, Frédéric Pène, Anders Perner, Elie Azoulay, Kathryn Puxty, Andry Van De Louw, Andreas Barratt-Due, Sanjay Chawla, Pedro Castro, Pedro Póvoa, Luis Coelho, Victoria Metaxa, Matthias Kochanek, Tobias Liebregts, Thomas Kander, Johanna Hästbacka, Jo Bønding Andreasen, Edwige Péju, Lene Bjerregaard Nielsen, Christine Lodberg Hvas, Etienne Dufranc, Emmanuel Canet, Linda Lundqvist, Christopher John Wright, Julien Schmidt, Fabrice Uhel, Hafid Ait-Oufella, Mette Krag, Elisabet Cos Badia, Cándido Díaz-Lagares, Sophie Menat, Guillaume Voiriot, Niels Erikstrup Clausen, Kristian Lorentzen, Reidar Kvåle, Thomas Hildebrandt, Aleksander Rygh Holten, Kristian Strand, Asterios Tzalavras, Morten Heiberg Bestle, Pål Klepstad, Sara Fernandez, Damien Vimpere, Carolina Paulino, Carina Graça, Catherina Lueck, Christian Svendsen Juhl, Carolina Costa, Per Martin Bådstøløkken, Teresa Miranda, Lia Susana Aires Lêdo, Joao Carlos Sousa Torres, Anders Granholm, Morten Hylander Møller, Lene Russell, on behalf of the PLOT-ICU Collaborators and the Nine-I Study Group

Published in: Intensive Care Medicine | Issue 11/2023

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. Non-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.

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Title: Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)
Authors: Carl Thomas Anthon
Frédéric Pène
Anders Perner
Elie Azoulay
Kathryn Puxty
Andry Van De Louw
Andreas Barratt-Due
Sanjay Chawla
Pedro Castro
Pedro Póvoa
Luis Coelho
Victoria Metaxa
Matthias Kochanek
Tobias Liebregts
Thomas Kander
Johanna Hästbacka
Jo Bønding Andreasen
Edwige Péju
Lene Bjerregaard Nielsen
Christine Lodberg Hvas
Etienne Dufranc
Emmanuel Canet
Linda Lundqvist
Christopher John Wright
Julien Schmidt
Fabrice Uhel
Hafid Ait-Oufella
Mette Krag
Elisabet Cos Badia
Cándido Díaz-Lagares
Sophie Menat
Guillaume Voiriot
Niels Erikstrup Clausen
Kristian Lorentzen
Reidar Kvåle
Thomas Hildebrandt
Aleksander Rygh Holten
Kristian Strand
Asterios Tzalavras
Morten Heiberg Bestle
Pål Klepstad
Sara Fernandez
Damien Vimpere
Carolina Paulino
Carina Graça
Catherina Lueck
Christian Svendsen Juhl
Carolina Costa
Per Martin Bådstøløkken
Teresa Miranda
Lia Susana Aires Lêdo
Joao Carlos Sousa Torres
Anders Granholm
Morten Hylander Møller
Lene Russell
on behalf of the PLOT-ICU Collaborators and the Nine-I Study Group
Publication date: 09-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: Thrombocytopenia
Platelet Transfusion
Septic Shock
Published in: Intensive Care Medicine / Issue 11/2023
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-023-07225-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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