Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia.
OBJECTIVE
To evaluate the prevalence and the prognostic value of thrombocytopenia in patients admitted to ICU for severe community-acquired pneumonia.


METHODS
Multicentre observational study was conducted in 7 ICUs in the north of France over a 19-year period (1987-2005). The primary outcome measure was the ICU mortality.


RESULTS
Eight hundred and twenty-two patients were studied. A platelet count < 150x10(9)/L was observed at ICU admission in 202 (25%) patients. Admission platelet count was between 101 and 149x10(9)/L, 51 and 100x10(9)/L, 21 and 50x10(9)/L, and < or = 20x10(9)/L in 100, 61, 32 and 9 patients, respectively. ICU mortality rate was 35.4%. Classifying patients into 3 categories with the following cut-offs of platelet count, > or = 150x10(9)/L, 51-149x10(9)/L, and < or = 50x10(9)/L, we observed a significant increase in ICU mortality rates which were 30.8% in the first group, 44.1% in the second group and 70.7% in the last one (p<0.0001). In multivariate analysis, thrombocytopenia < or = 50x10(9)/L appeared as an independent predictor of mortality (AOR=4.386).


CONCLUSIONS
In patients admitted to ICU for severe community-acquired pneumonia, thrombocytopenia has a high prevalence and influences the outcome.
Brogly
Nicolas
N
Service de Réanimation Médicale et Maladies Infectieuses, Université de Lille, Hôpital G. Chatiliez, 135 rue du Président Coty, 59208 Tourcoing, France.
Devos
Patrick
P
Boussekey
Nicolas
N
Georges
Hugues
H
Chiche
Arnaud
A
Leroy
Olivier
O
D017714:Community-Acquired Infections / Q000150:complications; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011014:Pneumonia / Q000150:complications* / Q000503:physiopathology; D015995:Prevalence; D011379:Prognosis; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications* / Q000453:epidemiology