Abstract

MARCO-SCHULKE, C.M. et al. Severe thrombocytopenia on admission to the intensive care unit in patients with multiple organ failure. Med. Intensiva [online]. 2012, vol.36, n.3, pp.185-192. ISSN 0210-5691.

Objective: To evaluate the frequency of severe thrombocytopenia (STCP) (< 50.000/µl) in the first 24hours in patients with multiple organ dysfunction syndrome, and the factors that influence its occurrence. Design: A retrospective, observational study. Area: Medical-surgical intensive care unit (ICU). Tertiary hospital. Patients: Those with failure of at least two organs, according to SOFA criteria, with the exclusion of neurological and traumatologic critical cases. Variables: Medical history, regular medication, baseline functional status, demographic variables, severity scores in ICU, multiple-organ failure data, course in ICU and main hospital data. Results: A total of 587 patients were included; 6.3% (37 patients) presented with STCP during the first day of admission; 64.6% were men; SOFA 8 (5-10); APACHE II 18 (13-24); APACHE IV 59 (46-73); 32.5% were surgical patients. A total of 79.9% subsequently needed mechanical ventilation, and 71.4% required vasoactive drugs. Overall stay in ICU: 4 (2-10) days, main hospital stay 18 (9-35) days. A total of 29.2% died in the ICU; 11.7% developed STCP during admission to the ICU. Multivariate analysis found the main determining factors in the occurrence of thrombocytopenia on admission to be: history of hospitalization in the last year, albumin and bilirubin levels, and sepsis. Conclusion: The prevalence of STCP among critical patients was 6.3%. Its occurrence was associated with albumin and bilirubin levels, sepsis, and with patient admittance in the last year.

Keywords : Thrombocytopenia; Severe thrombocytopenia; Coagulation; Sepsis; Mortality; Multiple organ failure.

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