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Thrombocytopenia in the intensive care unit
R P Baughman1, E E Lower, H C Flessa
1Department of Internal Medicine, University of Cincinnati.
Chest
|October 1, 1993
Summary
Thrombocytopenia, a low platelet count, is common in intensive care units (ICUs). It is often linked to underlying conditions and significantly increases patient mortality risk.
Area of Science:
- Critical Care Medicine
- Hematology
- Internal Medicine
Background:
- Thrombocytopenia (low platelet count) is a frequent complication in intensive care units (ICUs).
- Understanding its prevalence and associated risk factors is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of thrombocytopenia in an ICU setting.
- To identify factors associated with the development of thrombocytopenia.
Main Methods:
- Retrospective review of medical records for patients admitted to a university hospital medical ICU.
- Data collection included daily medications, clinical events, and platelet counts for patients surviving at least 12 hours.
- Bone marrow aspirates were performed in a subset of patients.
Main Results:
- The study evaluated 162 admissions, with 23% experiencing thrombocytopenia (platelet count < 100,000/mm3) and 10% severe thrombocytopenia (platelet count < 50,000/mm3).
- Independent risk factors for severe thrombocytopenia included sepsis, antineoplastic chemotherapy, elevated creatinine, and elevated bilirubin.
- Thrombocytopenia was significantly associated with longer hospital stays and increased mortality (p < 0.001).
Conclusions:
- Thrombocytopenia is a common finding in ICUs, frequently stemming from the patient's underlying illness.
- The presence of thrombocytopenia is a significant indicator of increased mortality in the ICU population.