title: The incidence, causes, and prognostic significance of new-onset thrombocytopenia in intensive care units: a prospective cohort study in a Korean hospital.
abstract: This study was designed to investigate the incidence, causes, and outcomes of new-onset thrombocytopenia (NOT) in Korean intensive care units (ICUs). A prospective cohort study was conducted in medical ICUs of Samsung Medical Center between August 2010 and February 2011. All newly admitted patients were included if they stayed in the ICU for more than 48 hr and did not have thrombocytopenia upon admission. A total of 186 patients were included. NOT developed in 37.1%. Most common cause of NOT was sepsis with disseminated intravascular coagulation (66.7%), followed by drug-induced thrombocytopenia (18.8%), and heparin-induced thrombocytopenia (2.9%). IgG-specific antibody to platelet factor 4/heparin was positive in 2.4% among patients treated with heparin, and thrombosis occurred in two patients. Twenty eight-day mortality was higher in patients that developed NOT compared to those that did not develop NOT (39.1% vs 12%, P < 0.001). NOT increased the odds ratio of 28-day mortality and was an independent risk factor for mortality (OR 3.52; 95% CI 1.32-9.38; P = 0.012). In conclusion, NOT is common and is an independent risk factor for mortality in Korean ICU patients. Therefore, clinicians should make every effort to correct the causes of NOT.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lim
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Jeon
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Um
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D006493:Heparin / Q000276:immunology; D006761:Hospitals; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010978:Platelet Factor 4 / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D018805:Sepsis / Q000150:complications; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D013927:Thrombosis / Q000209:etiology
chemical_list: D007074:Immunoglobulin G; D010978:Platelet Factor 4; D006493:Heparin