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Duration of platelet storage and outcomes of critically ill patients
Andrew Flint1,2, Cécile Aubron1,3,4, Michael Bailey1
1The Australian and New Zealand Intensive Care Research Centre.
Insights
Platelet (PLT) storage duration, typically 5-7 days, was not linked to increased mortality or infection in critically ill patients. This large observational study found no significant outcome differences based on PLT storage length.
Area of Science:
- Critical Care Medicine
- Transfusion Medicine
- Hematology
Background:
- Platelet (PLT) transfusion is a critical intervention for critically ill patients.
- The storage duration of PLT units is limited, raising questions about its impact on patient outcomes.
Purpose of the Study:
- To investigate the association between platelet storage duration and patient outcomes in critically ill individuals.
- To determine if longer storage times for PLTs increase risks of mortality or infection.
Main Methods:
- Retrospective analysis of critically ill patients receiving PLT transfusions in Australian ICUs (2008-2014).
- Evaluation of outcomes including hospital mortality and ICU-acquired infection.
- Statistical analysis using multiple logistic regression and Cox regression to adjust for confounders.
Main Results:
- Among 1430 patients with available PLT storage data, in-hospital mortality was 22.1% and ICU infection rate was 7.2%.
- No significant differences in mortality or infection rates were observed when comparing PLTs stored for ≤3, 4, or 5 days.
- Adjusted analyses confirmed that PLT storage duration was not independently associated with increased mortality or infection risk.
Conclusions:
- In a large, heterogeneous ICU population, the storage duration of platelets was not associated with an increased risk of mortality.
- Similarly, PLT storage duration did not correlate with an increased risk of ICU-acquired infection.
- These findings suggest that current PLT storage guidelines may be adequate for critically ill patients.
Background:
The storage duration of platelet (PLT) units is limited to 5 to 7 days. This study investigates whether PLT storage duration is associated with patient outcomes in critically ill patients.
Study Design And Methods:
This study was a retrospective analysis of critically ill patients admitted to the intensive care unit (ICU) of two hospitals in Australia who received one or more PLT transfusions from 2008 to 2014. Storage duration was approached in several different ways. Outcome variables were hospital mortality and ICU-acquired infection. Associations between PLT storage duration and outcomes were evaluated using multiple logistic regression and also by Cox regression.
Results:
Among 2250 patients who received one or more PLT transfusions while in the ICU, the storage duration of PLTs was available for 64% of patients (1430). In-hospital mortality was 22.1% and ICU infection rate 7.2%. When comparing patients who received PLTs of a maximum storage duration of not more than 3, 4, or 5 days, there were no significant differences in baseline characteristics. After confounders were adjusted for, the storage duration of PLTs was not independently associated with mortality (4 days vs. ≤3 days, odds ratio [OR] 0.88, 95% confidence interval [CI] 0.59-1.30; 5 days vs. ≤3 days, OR 0.97, 95% CI 0.68-1.37) or infection (4 days vs. ≤3 days, OR 0.71, 95% CI 0.39-1.29; 5 days vs. ≤3 days, OR 1.11, 95% CI 0.67-1.83). Similar results were obtained regardless of how storage duration of PLTs was approached.
Conclusions:
In this large observational study in a heterogeneous ICU population, storage duration of PLTs was not associated with an increased risk of mortality or infection.
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