Muhammad Siddique, Sayyed Naveed Masood, Rubeena Nazli Shaffi, Asad Ullah Jaafri, Fayyaz Hussain.
Thrombocytopenia in critically ill surgical patients; a study evaluating attributable patient`s mortality and transfusion requirement.
Professional Med J Jan ;13(1):138-44.

Thrombocytopenia is a well known complication in the surgical intensive care 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, has not been confirmed by previous studies. We performed a case control study in surgical intensive care unit of Combined Military Hospital Rawalpindi in which 119 critically ill surgical patients developed thrombocytopenia of less than 50x10e9 platelets/L. These patients were carefully matched with control patients for the severity of underlying disease and important variables. Purpose of study was to evaluate attributable mortality and transfusion requirement in thrombocytopenic 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 probabilities 0.036). The estimated at tributable mortality rate was 18.4% (95% confidence interval 3.12-11.8) and the estimated odds ratio 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 less than 50x10e9/L seems to be a marker of severity the illness and increases risk of death. Thrombocytopenia also leads to more blood product consumption.

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