Thrombocytopenia in Critically Ill Adult Patients in Medical Intensive Care Unit (ICU):Frequency and Risk Factors in King Fahad Central Hospital, Jazan, KSA
Background: Thrombocytopenia is defined as a platelet count of less than
150 ÃÂ 109/l. The various comorbidities in the severely ill patient affect platelet homeostasis, and consequently, thrombocytopenia is very common in critically ill patients treated in the ICU.
Objective: To assess the frequency of thrombocytopenia in patients admitted to the medical intensive care unit (ICU) of King Fahad Central Hospital and its risk factors, during the period from October 2018-January 2019.
Methodology: Data were collected from 160 adult patients admitted to the ICU.
The baseline platelet count was measured and was repeated every other day (for one-week) during the ICU stay period. Thrombocytopenia was defined as platelet count of less than 150x109/l.
Results: Among 160 critically ill patients admitted to ICU, 92 (57.5%) were males and 68 (42.5%) were females. The majority of them 72 (45%) found in age group >60 years. The mean of platelets at admission was 237.6 ÃÂ± 4.6 and after one-week the mean of platelets was 121 ÃÂ± 31.8 (P=0.000). The prevalence of thrombocytopenia was 70%. Thrombocytopenia was significantly developed in the patients found in age group >60 years (50%) (P=0.008). The occurrence of thrombocytopenia was significantly high in the patients received thromboprophylaxis (75%; P=0.000), antibiotic (89.3%; P=0.000), sedation and mechanical ventilator support (50%; P=0.003). Additionally the SOFA score was significantly high in the patients with thrombocytopenia (5.0 ÃÂ± 0.2 vs. 3.7 ÃÂ± 0.3; P=0.002) and all the patients (n=4; 100%) with score 10-12 and the most of the patients (85.7%) with score 7-9 developed thrombocytopenia (P=0.046).
Conclusion: Thrombocytopenia is common in critically ill patients admitted in the ICU. Also, thrombocytopenia was significantly associated with elders, in addition to the patients received thromboprophylaxis, antibiotic, sedation and mechanical ventilator support as well as the patients with higher SOFA score.
Rania Osman A, Hassna Ali, Hala Musa and Nidal Ali