• Medicina intensiva · Apr 2012

    [Severe thrombocytopenia on admission to the intensive care unit in patients with multiple organ failure].

    • C M Marco-Schulke, M Sánchez-Casado, V A Hortigüela-Martín, M Quintana-Díaz, S Rodríguez-Villar, M J Pérez-Pedrero, A Velasco-Ramos, A Canabal-Berlanga, and M Á Arrese-Cosculluela.
    • Servicio de Medicina Intensiva, Complejo Hospitalario de Toledo, Toledo, España. marcel55@terra.es
    • Med Intensiva. 2012 Apr 1;36(3):185-92.

    ObjectiveTo evaluate the frequency of severe thrombocytopenia (STCP) (≤ 50,000/μl) in the first 24 hours in patients with multiple organ dysfunction syndrome, and the factors that influence its occurrence.DesignA retrospective, observational study. AREA: Medical-surgical intensive care unit (ICU). Tertiary hospital.PatientsThose with failure of at least two organs, according to SOFA criteria, with the exclusion of neurological and traumatologic critical cases.VariablesMedical history, regular medication, baseline functional status, demographic variables, severity scores in ICU, multiple-organ failure data, course in ICU and main hospital data.ResultsA 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.ConclusionThe 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.Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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