Low physical activity levels and poorer muscle strength are associated with reduced physical function at intensive care unit discharge: An observational study

Abstract

Objectives: To explore the differences in patients with hepatic and gastrointestinal disease receiving PCC and/or FFP during bleeding episodes or in surgery. Methods: A single-centre retrospective observational cohort study of patients with severe coagulopathy or active bleeding in a university hospital. Results: We studied 40 patients receiving FFP only (18, 45%), PCC only (7, 17.5%) or both (15, 37.5%) during a hospital admission; their median age was 55 (46.5–63) years and 35% of patients were female. 40% of patients developed a composite outcome of death in hospital or thromboembolic complication. Compared to those receiving FFP alone, patients receiving PCC with FFP or only PCC were significantly more likely to develop the composite outcome (OR=12, 95% CI: 1.99–72.35, p=0.007 and OR=20, 95% CI: 2.21–180.9, p=0.008 respectively). The reason for admission to ICU (p=0.06) and the need for CRRT (p=0.074) were included in multivariate logistic regression analysis. Compared to those receiving FFP alone, PCC administration with or without FFP remained an independent predictor of outcome (OR=10.5, 95% CI: 1.43–76.93, p=0.021 and OR=18.21, 95% CI: 1.54–215.13, p=0.021), while admission to ICU for liver pathology or intervention appeared to be protective (OR=0.12, 95% CI: 0.02–0.91, p=0.041). Conclusion(s): There is an independent association between PCC administration and the composite outcome of death or thromboembolic complications in hospital. PCC may contribute to these events, or be a marker of illness severity, or both. Further exploration is warranted.