Prognostic impact of persistent versus transient sepsis-associated thrombocytopenia in multicohort data

Thrombocytopenia (TP) in patients with sepsis is associated with adverse outcomes. Previous research has predominantly focused on the severity of TP, while the prognostic impact of its duration remains insufficiently explored. This study aimed to investigate the association between the duration of sepsis-associated thrombocytopenia (SAT) and clinical outcomes. Over a 28-day observation period, patients with persistent TP (duration > 3 days) had significantly fewer ventilator-free days, intensive care unit (ICU)-free days, and hospital-free days (all p < 0.001) than those with transient TP (resolution within 1-3 days). Persistent TP was associated with significantly increased mortality (p < 0.001) and transfusion rates (p < 0.001). Multivariable logistic regression analysis revealed that transient TP was not significantly associated with in-hospital mortality (p > 0.05), whereas persistent TP remained an independent risk factor (p < 0.05). A 3-day cutoff to differentiate between transient and persistent SAT demonstrated significant clinical utility. The duration of TP offers additional, valuable prognostic information, potentially guiding risk stratification and therapeutic strategies.