Frequency of Thrombocytopenia and its Association with Short-Term Outcomes among ICU Patients

Abstract

Abstract: Background: Thrombocytopenia can result from various etiologies. The development of thrombocytopenia in critically ill patients is associated with increased bleeding and transfusion risk and, hence, higher mortality.

Objective: To determine the frequency of thrombocytopenia and its association with short-term outcomes in patients admitted to the Medical ICU of the tertiary care center.

Materials and Methods: A prospective observational study was conducted in the Medical Intensive Care Unit (MICU) at The Indus Hospital, Karachi, from March to September 2023. The study obtained the permission from the Ethical Review Board of Indus Hospital (IRB#: IHHN_IRB_2023_01_022). Each patient was followed with a platelet count on the first, third, fifth, and seventh day. Patients’ outcomes in terms of aliveness or death were noted on the first, third, fifth, and seventh days.

Result: The study included 152 patients with a mean age of 42.50 ± 18.11 years. On admission, thrombocytopenia was seen in 42%. The frequency at day 3, day 5, and day 7 was 50%, 56.1%, and 50.4%, respectively. At day 5, a significant association was found between mortality and thrombocytopenia, with 68.5% mortalities among thrombocytopenia patients and 31.5% mortality among patients without thrombocytopenia (p=0.002).  The association becomes even more obvious by day 7, where thrombocytopenia was found to be strongly linked to mortality, with a higher mortality rate of 68% among those with thrombocytopenia than a 31% death rate among those without thrombocytopenia (p<0.001).

Conclusion: Thrombocytopenia was common in MICU and correlated with short-term mortality. The findings indicate the prognostic role of platelet count. To confirm these findings, more multicenter investigations with a bigger sample size and modified analysis are required.