THROMBOCYTOPENIA IN CRITICALLY ILL SURGICAL PATIENTS

Abstract

Thrombocytopenia is a well known complication in the surgical intensivecare unit (ICU) patients. The influence of thrombocytopenia on patient’s mortality is difficult to assess.Thrombocytopenia results in increased mortality and transfusion requirement of platelets and other blood products, hasnot been confirmed by previous studies. We performed a case control study in surgical intensive care unit of CombinedMilitary Hospital Rawalpindi in which 119 critically ill surgical patients developed thrombocytopenia of less than 50x109platelets/L. These patients were carefully matched with control patients for the severity of underlying disease andimportant variables. Purpose of study was to evaluate attributable mortality and transfusion requirement inthrombocytopenic patients at that unit.. Fifty-two (44%) cases died versus forty (33%) control patients. Eighty one (76%)matched pairs had a concordant outcome and in 25% of those pairs, the cases died (exact binomial probabilities0.036). The estimated attributable mortality rate was 18.4% (95% confidence interval 3.12-11.8) and the estimated oddsratio was 2.6 (95% confidence interval 1.02-7.10). The estimated attributable transfusion requirement was 23% (95%confidence interval 5.3-43.5) and the estimated odds ratio was 1.51.This study suggests that thrombocytopenia of lessthan 50x10 /L seems to be a marker 9 of severity the illness and increases risk of death. Thrombocytopenia also leadsto more blood product consumption.