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Clinical significance of thrombocytopenia in patients with septic shock: An observational retrospective study.
Péju, Edwige; Fouqué, Gaëlle; Charpentier, Julien; Vigneron, Clara; Jozwiak, Mathieu; Cariou, Alain; Mira, Jean-Paul; Jamme, Matthieu; Pène, Frédéric.
Afiliación
  • Péju E; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Université Paris Cité, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Cité, 22 rue Méchain, 75014 Paris, Fr
  • Fouqué G; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
  • Charpentier J; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
  • Vigneron C; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Université Paris Cité, Paris, France.
  • Jozwiak M; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
  • Cariou A; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Université Paris Cité, Paris, France.
  • Mira JP; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Université Paris Cité, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Cité, 22 rue Méchain, 75014 Paris, Fr
  • Jamme M; Service de médecine intensive-réanimation, Hôpital Privé de l'Ouest Parisien, Ramsay Générale de Santé, 14 Rue Castiglione del Lago, 78190 Trappes, France; Centre de Recherche en Epidémiologie et Santé des Populations, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), INSERM U-1018, Université
  • Pène F; Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris Centre, 27 rue du faubourg Saint Jacques, 75014 Paris, France; Université Paris Cité, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Cité, 22 rue Méchain, 75014 Paris, Fr
J Crit Care ; 76: 154293, 2023 08.
Article en En | MEDLINE | ID: mdl-36989886
PURPOSE: Whether thrombocytopenia in critically ill patients accounts for a bystander of severity or drives specific complications is unclear. We addressed the effect of thrombocytopenia on septic shock, with emphasis on intensive care unit (ICU)-acquired bleeding, infections and thrombotic complications. MATERIALS AND METHODS: A retrospective (2008-2019) single-center study of patients with septic shock. Thrombocytopenia was assessed over the first seven days and was defined as severe (nadir <50 G/L), mild (nadir 50-150 G/L) and relative (30% decrease with nadir >150 G/L). Outcomes were ICU mortality and ICU-acquired complications defined by severe bleeding, infections and thrombotic events during the ICU stay. RESULTS: The study comprised 1024 patients. Severe, mild and relative thrombocytopenia occurred in 33%, 40% and 9% of patients. The in-ICU mortality rate was 27%, independently associated with severe thrombocytopenia. ICU-acquired infections, hemorrhagic and thrombotic complications occurred in 27.5%, 13.3% and 11.6% of patients, respectively. Patients with severe, mild or relative thrombocytopenia exhibited higher incidences of bleeding events (20.3%, 15.3% and 14.4% vs. 3.6% in non-thrombocytopenic, p < 0.001), infections (35.2%, 21.9% and 33.3% vs. 23.1% in non-thrombocytopenic, p < 0.001) and thrombotic events (14.6%, 10.8% and 17.8% vs. 7.8% in non-thrombocytopenic, p = 0.03). Only severe thrombocytopenia remained independently associated with increased risk of bleeding. CONCLUSIONS: Severe thrombocytopenia was independently associated with ICU mortality and increased risk of bleeding, but not with infectious and thrombotic events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD Problema de salud: 4_sepsis Asunto principal: Choque Séptico / Trombocitopenia Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD Problema de salud: 4_sepsis Asunto principal: Choque Séptico / Trombocitopenia Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2023 Tipo del documento: Article
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