Thrombocytopenia in critically ill surgical patients: a case-control study evaluating attributable mortality and transfusion requirements
Background:
That thrombocytopenia results in increased mortality or
transfusion requirements has not been confirmed by previous studies. We
performed a case-control study in which 36 patients who developed severe
thrombocytopenia of less than 50×109 platelets/l were carefully
matched for the severity of underlying disease and other important
variables.
Results:
Seventeen (47%) thrombocytopenic patients died, versus 10 (28%)
matched control patients who were not thrombocytopenic.Nine pairs had a
discordant outcome, and in eight of these pairs the thrombocytopenic patient
died (exact binomial probability 0.037). The estimated attributable mortality
was 19.5% (95% confidence interval 3.2⌓35.8), and the estimated odds ratio was
2.7 (95% confidence interval 1.02⌓7.10). Thrombocytopenic patients had
comparable values for severity of illness scores between day of admission and
day of thrombocytopenia, in contrast with control patients who had a
statistically significant decrease in severity of illness scores during the
same period. Thirty (83%) of the thrombocytopenic patients required transfusion
of blood products, versus 21 (58%) control patients (paired χ2
test 4.92, P < 0.04). The estimated attributable transfusion
requirement was 25% (95% confidence interval 5.4⌓44.6), and the estimated odds
ratio was 1.52 (95 confidence interval 1.05⌓2.20).
Conclusion:
The present study suggests that thrombocytopenia of less than
50 × 109 platelets/l may be a marker for more severe illness and
increased risk of death, rather than causative, because a true causal
relationship is not established. Thrombocytopenia also leads to an excess of
blood product consumption.
Complete Metadata
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| description | Background: That thrombocytopenia results in increased mortality or transfusion requirements has not been confirmed by previous studies. We performed a case-control study in which 36 patients who developed severe thrombocytopenia of less than 50×109 platelets/l were carefully matched for the severity of underlying disease and other important variables. Results: Seventeen (47%) thrombocytopenic patients died, versus 10 (28%) matched control patients who were not thrombocytopenic.Nine pairs had a discordant outcome, and in eight of these pairs the thrombocytopenic patient died (exact binomial probability 0.037). The estimated attributable mortality was 19.5% (95% confidence interval 3.2⌓35.8), and the estimated odds ratio was 2.7 (95% confidence interval 1.02⌓7.10). Thrombocytopenic patients had comparable values for severity of illness scores between day of admission and day of thrombocytopenia, in contrast with control patients who had a statistically significant decrease in severity of illness scores during the same period. Thirty (83%) of the thrombocytopenic patients required transfusion of blood products, versus 21 (58%) control patients (paired χ2 test 4.92, P < 0.04). The estimated attributable transfusion requirement was 25% (95% confidence interval 5.4⌓44.6), and the estimated odds ratio was 1.52 (95 confidence interval 1.05⌓2.20). Conclusion: The present study suggests that thrombocytopenia of less than 50 × 109 platelets/l may be a marker for more severe illness and increased risk of death, rather than causative, because a true causal relationship is not established. Thrombocytopenia also leads to an excess of blood product consumption. |
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| identifier | https://healthdata.gov/api/views/jk28-pd3f |
| issued | 2025-07-13 |
| keyword |
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| title | Thrombocytopenia in critically ill surgical patients: a case-control study evaluating attributable mortality and transfusion requirements |
