Thrombocytopenia and outcome in critically ill patients with bloodstream infection.
OBJECTIVE
Thrombocytopenia is common in intensive care units (ICUs), and is associated with a poor prognosis. An acute decrease in total platelet count is frequently observed in severe sepsis, followed by a relative increase indicating organ-failure recovery. However, few data are available describing this effect and its relationship with outcomes in specific subgroups of ICU patients.


METHODS
A retrospective, observational cohort study was conducted to investigate the incidence and prognosis of thrombocytopenia in a cohort of critically ill patients (n=155) with a microbiologically documented nosocomial bloodstream infection.


RESULTS
Thrombocytopenia occurred more frequently in nonsurvivors. The ICU mortality rates increased according to severity of thrombocytopenia. Thrombocytopenia was independently associated with worse outcomes in ICU patients with nosocomial bloodstream infection.


CONCLUSIONS
Determining trends in platelet counts is of additional prognostic value, compared with single measurements.
Vandijck
Dominique M
DM
Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium. Dominique.Vandijck@UGent.be
Blot
Stijn I
SI
De Waele
Jan J
JJ
Hoste
Eric A
EA
Vandewoude
Koenraad H
KH
Decruyenaere
Johan M
JM
D000328:Adult; D000368:Aged; D016638:Critical Illness; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications*; D013921:Thrombocytopenia / Q000209:etiology* / Q000401:mortality