title: An evidence-based threshold for thrombocytopenia associated with clinically significant bleeding in pediatric intensive care unit patients.
abstract: OBJECTIVE
  To determine the epidemiology and identify the risk factors for clinically significant bleeding in the pediatric intensive care unit.
  
  
  METHODS
  A retrospective cohort study over 6 months with up to 7 days of observation for each patient.
  
  
  METHODS
  The pediatric intensive care unit in a tertiary care children's hospital.
  
  
  METHODS
  Three hundred twenty-six consecutive patients admitted to the pediatric intensive care unit during the study period, with 214 eligible for inclusion.
  
  
  RESULTS
  Clinically significant bleeding, defined using a composite of outcomes. Clinically significant bleeding occurred in 19 patients (8.9%). Recursive partitioning identified a platelet count <100 × 10/L as being associated with clinically significant bleeding. Other factors associated with increased risk included mechanical ventilation, antibiotic and antacid medications, the performance of multiple procedures, and cardiac surgery. Episodes of clinically significant bleeding were observed at a median of 9.8 hrs after admission.
  
  
  CONCLUSIONS
  Clinically significant bleeding is a more common complication for pediatric intensive care unit patients than has been previously reported. The evidence-based threshold for thrombocytopenia identified as a risk factor should be further investigated in a prospective study.
authors: From the Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada. pmoorehead@yahoo.com
authors: Paul C
authors: PC
authors: Moorehead
authors: Janelle
authors: J
authors: Cyr
authors: Robert
authors: R
authors: Klaassen
authors: Nicholas J
authors: NJ
authors: Barrowman
authors: Kusum
authors: K
authors: Menon
mesh_terms: D000293:Adolescent; D000863:Antacids; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D006470:Hemorrhage / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009864:Ontario / Q000453:epidemiology; D010976:Platelet Count; D015995:Prevalence; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000150:complications*
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents