Thrombocytopenia and association with clinical outcomes in patients with sepsis and sepsis shock

Abstract

Background: Thrombocytopenia is a common problem in critically ill patients with sepsis and septic shock. Both thrombocytopenia and high mean platelet volume (MPV) were considered poor prognostic factors, as they were associated with increased multi-organ failure, bleeding, length of ICU stay, and mortality in the intensive care unit. The study aimed to evaluate the relationship between thrombocytopenia and high mean platelet volume with clinical outcomes in patients with sepsis and sepsis shock. Methods: A cross-sectional study was conducted on 112 patients above 16 years old who were diagnosed with sepsis and septic shock according to the Sepsis-3 definition from January 2022 to May 2023. Results: 55.4% of patients were male, a mean age of 66 years with 54.5% sepsis, and 45.5% sepsis shock. 57/112 (50.9%) had thrombocytopenia, with mild, moderate, and severe thrombocytopenia rates of 27.7%, 17.9%, and 5.4%, respectively. The gastrointestinal (43.8%) and respiratory (37.5%) tracts were the two most common sites of infection followed by P. aeruginosa (32.3%) and E. coli (29%) being the most commonly isolated pathogen. Sepsis and sepsis shock patients with thrombocytopenia had prolonged ICU stay (6 days vs. 4 days), high rates of multi-organ dysfunction (96.5% vs. 69.1%), and high mortality rates (49.1% vs. 10.9%) compared to those without thrombocytopenia, with p < 0.01. Thrombocytopenia is a risk factor for mortality with OR = 5.2 (95%CI [1.30 - 20.68], p < 0.05). The MPV in the non-survival (10.37 ± 1.55) was higher than the surviving group’s (9.63 ± 1.62), respectively. Conclusion: Thrombocytopenia was present in 50.9% of critically ill patients with sepsis and sepsis shock. Thrombocytopenia and increased MPV are prognostic factors for poor clinical outcomes in sepsis and sepsis shock patients. Key words: thrombocytopenia, mean platelet volume, sepsis, sepsis shock, mortality rate.