Prospective evaluation of bleeding risk among thrombocytopenic patients admitted in intensive care unit.
J Crit Care
; 79: 154405, 2024 02.
Article
em En
| MEDLINE
| ID: mdl-37659243
ABSTRACT
PURPOSE:
Bleeding risk evaluation of thrombocytopenic patients admitted in ICU has been poorly investigated.METHODS:
A prospective observational study conducted in an 18-bed medical ICU. Consecutive patients with thrombocytopenia (<150 Giga/L) and no bleeding at admission were included.RESULTS:
Over one year, 91 patients were included, mainly men (63%), with an age of 61 [46-68] years and a SOFA score of 6 [3-8]. Twenty-three patients (25%) had an hemorrhagic event during ICU stay, mainly digestive (n = 9; 39%) and urological (n = 6; 26%). The time between ICU admission and bleeding was 8 [2-19] days. Almost half of bleeding events required vasopressor infusion and a hemostatic procedure. At admission, two variables were significantly different between the Bleeding and No-Bleeding groups plasma urea level was significantly higher in the Bleeding group (9 [5.1; 13] vs. 13 [8.9; 31] mmol/L; p < 0.001) and the presence of skin purpura was associated with a 3-fold higher risk for bleeding during ICU stay (HR 3.4 [1.3-8.3]; p < 0.05). In contrast, admission platelet count was not significantly different between the 2 groups (90 [32; 128] vs 62 [36; 103] G/L; p = 0.26).CONCLUSION:
Plasma urea levels and the presence of skin purpura are helpful in identifying thrombocytopenic patients at high-risk of bleeding during ICU stay.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Púrpura
/
Trombocitopenia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article