title: Thrombocytopenia in critically ill patients with severe sepsis/septic shock: Prognostic value and association with a distinct serum cytokine profile.
abstract: OBJECTIVE
  The purpose of the study is to evaluate the incidence, association with serum cytokine profile, and prognostic value of thrombocytopenia, in critically ill patients with severe sepsis/septic shock.
  
  
  METHODS
  A cohort of 105 consecutive patients admitted in intensive care unit was included in our analysis. Serum levels of intercellular adhesion molecule, vascular cell adhesion molecule, interferon γ, interleukin 8, and soluble form of the urokinase-type plasminogen activator receptor (suPAR) were measured.
  
  
  RESULTS
  Thrombocytopenia was observed in 53% of patients at the time of admission. Platelet counts showed a statistically significant negative correlation with serum levels of intercellular adhesion molecule, suPAR, and interleukin 8 (P < .0001). In multivariate analysis, high Acute Physiological and Chronic Health Evaluation II score, high serum suPAR, and low platelet counts were associated with increased mortality, and receiver operating characteristic curve analysis was used to determine the best cutoff value for mortality prediction. Each variable with a value above or below the predefined cutoff levels were given 1 point. Patients were categorized in risk groups based on total point score. High-risk (2-3), intermediate-risk (1), and low-risk (0 points) groups consisted of 43%, 22%, and 35% and 28-day mortality was observed in 69%, 26%, and 3% of the patients in each group, respectively.
  
  
  CONCLUSIONS
  Thrombocytopenia is associated with poor prognosis and a distinct serum cytokine profile.
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: panagtsirigotis@gmail.com.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsirigotis
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Spiros
authors.initials: S
authors.lastname: Chondropoulos
authors.affiliation: 2nd Department of Critical Care, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Frantzeska
authors.initials: F
authors.lastname: Frantzeskaki
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Stamouli
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gkirkas
authors.affiliation: Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Bartzeliotou
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanikolaou
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Atta
authors.affiliation: Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papassotiriou
authors.affiliation: 2nd Department of Internal Medicine, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Dimitriadis
authors.affiliation: 2nd Department of Critical Care, "ATTIKO" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Dimopoulou
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D013921:Thrombocytopenia / Q000097:blood* / Q000150:complications / Q000401:mortality
chemical_list: D015415:Biomarkers; C508606:CXCL8 protein, human; D016207:Cytokines; D016209:Interleukin-8; D055293:Receptors, Urokinase Plasminogen Activator
keywords: Endothelium; ICAM; IL-8; Sepsis; Thrombocytopenia; suPAR