THROMBOCYTOPENIA IN THE INTENSIVE-CARE UNIT

Study objective: To determine the prevalence of thrombocytopenia in an ICU and assess which factors were associated with thrombocytopenia. D esign: A review of the medical records of patients admitted during 3 s eparate months during 1 academic year. Patients must have survived at least 12 h in the ICU. Setting: A medical ICU at a university hospital . Patients: General medicine patients admitted to the ICU. Interventio ns: All medical records were reviewed. During the ICU stay, daily medi cations, events, and platelet count were noted. All patients were foll owed up until death or hospital discharge. In 22 patients, including 1 8 who had thrombocytopenia, bone marrow aspirates were performed. Meas urements and results: One hundred sixty-two admissions were evaluated. Thirty-eight (23 percent) had platelet counts less than 100,000/mm3 a t least once, and 17 (10 percent) patients had platelet counts less th an 50,000/mm3. Several factors were associated with thrombocytopenia; however, only sepsis, use of antineoplastic chemotherapy, elevated cre atinine level, or elevated bilirubin value were independent risk facto rs for severe thrombocytopenia. In only one patient were the bone marr ow findings different from those expected by the clinical presentation . Thrombocytopenia was associated with longer hospital stay (p<0.001) and higher mortality (p<0.001). Conclusion: Thrombocytopenia is a comm on occurrence in the ICU, usually due to the underlying disease, and i s associated with an increased mortality.