The incidence of thrombocytopenia and mortality in ICU patients of Imam Hossein hospital

Thrombocytopenia is common in ICU patients. The objective of this study was to evaluate possible links between platelet counts and survival in ICU patients. All patients who were admitted to the Imam Hossein Medical Center ICU for at least 2 days and were 18 years or older with absence of thrombocytopenia at the time of admission were included in this retrospective study. A multivariate logistic regression model was used to examine thrombocytopenia and ICU mortality as the outcome variable. From 565 patients admitted in that ICU during the study period, 394 matched the inclusion criteria. The incidence of thrombocytopenia was 57.5% and mortality was 61.4%. Mortality rate was 28.5 % in thrombocytic patients vs. 9.2% in non-thrombocytic patients (p‹0.001). Patients with ICU acquired thrombocytopenia had statistically significant lower baseline, minimum and 4th day platelet counts. Female sex, longer ICU stay, admission platelet counts, and albumin levels were significantly associated with occurrence of thrombocytopenia. Higher platelet counts on admission were associated with significantly reduced risk of thrombocytopenia (P=0.00). On multivariate regression analysis age, ICU acquired thrombocytopenia, higher INR, higher mean APACHE II score, renal replacement therapy, and mechanical ventilation were significantly associated with mortality. The incidence of thrombocytopenia and subsequent mortality in ICUs is considerably high and is a real medical concern. In patients, who spend ≥ 2 days in the ICU and have normal platelet counts at ICU admission, a decline in platelet counts to less than 150,000/mL is an indicator of poor prognosis.