Journal of Medical and Surgical Intensive Care Medicine 2016 , Vol 7, Issue 1
Incidence of Thrombocytopenia in Patients Hospitalized in the Intensive Care Unit and Factors Affecting the Development of Thrombocytopenia
Ramazan Coşkun 1 , Nilgün Özlem Alptekinoğlu Mendil 1 , Gülseren Elay 1 , İlhan Bahar 1 , Zahide Karaca 1 , Kürşat Gündoğan 1 , Murat Sungur 1 , Muhammet Güven 1 , Mücahit Mustafa Kaya 2
1Erciyes Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Yoğun Bakım Bilim Dalı, Kayseri, Türkiye
2Erciyes Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Kayseri, Türkiye
DOI : 10.5152/dcbybd.2015.808

Objective: Thrombocytopenia is common in intensive care units (ICUs) and is associated with high mortality. The aim of this study was to determine the incidence of thrombocytopenia and to evaluate the factors affecting the development of thrombocytopenia in patients who stayed at a medical intensive care unit (MICU).

Material and Methods: This study was conducted retrospectively in a MICU. The data were obtained from patients’ folders and the hospital’s electronic records system. Patients who stayed for more than 24 h in the ICU were included in the study. The demographic data, the worst laboratory values in the first 24 h, the lowest platelet counts, and medications that can cause thrombocytopenia were recorded.

Results: A total of 237 patients were included in this study; 106 of them (45%) were female and 131 (55%) were male. Their average age was 62±18 years. The most common reasons for hospitalization in the ICU were respiratory failure (33%) and neurological diseases (13%). During follow-up, 45% of the patients developed thrombocytopenia. The mean APACHE-II score was 24±10 and SOFA score was 9±4. The mean MODS score was 6±3, and it was higher in the patients who developed thrombocytopenia than those who did not (p<0.0001). Upon analyzing the factors affecting the development of thrombocytopenia, prophylactic or therapeutic heparin use was determined in 61% of the patients. It was determined that 106 patients (45%) were using one or more drugs that can trigger thrombocytopenia. The patients who developed thrombocytopenia stayed longer in the ICU (p=0.042), and their overall mortality rate was higher than those who did not develop thrombocytopenia (91% vs. 55%; p<0.0001).

Conclusion: Thrombocytopenia is common in ICUs. Drugs used in ICUs can lead to the development of thrombocytopenia. The mortality rate among patients who develop thrombocytopenia is high. 

Keywords : Drugs, critical care, mortality, thrombocytopenia