Thrombocytopenia and outcome in critically ill patients with bloodstream infection

OBJECTIVE: Thrombocytopenia is common in intensive care units (ICUs), and is associated with a poor prognosis. An acute decrease in total platelet count is frequently observed in severe sepsis, followed by a relative increase indicating organ-failure recovery. However, few data are available describing this effect and its relationship with outcomes in specific subgroups of ICU patients. METHODS: A retrospective, observational cohort study was conducted to investigate the incidence and prognosis of thrombocytopenia in a cohort of critically ill patients (n = 155) with a microbiologically documented nosocomial bloodstream infection. RESULTS: Thrombocytopenia occurred more frequently in nonsurvivors. The ICU mortality rates increased according to severity of thrombocytopenia. Thrombocytopenia was independently associated with worse outcomes in ICU patients with nosocomial bloodstream infection. CONCLUSION: Determining trends in platelet counts is of additional prognostic value, compared with single measurements. (Heart Lung(R) 2010;39:21-26)