Original Research
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction: Thrombocytopenia has been associated with poorer clinical outcomes in the intensive care unit (ICU) including increased risk of bleeding, prolonged length of stay, and mortality.
Research Question or Hypothesis: Which patient-specific characteristics are associated with thrombocytopenia in critically ill patients?
Study Design: A retrospective analysis was performed using the electronic health records of 318 critically ill adult patients from February 1 to August 30, 2020.
Methods: Thrombocytopenia was defined as a serum platelet count < 150 x 103/mcL. Thrombocytopenia outcomes were custom-coded using R-programming language. The primary outcome was the incidence of thrombocytopenia, and secondary outcomes were the risk factors associated with the disease and all-cause mortality during hospitalization. Descriptive statistics were conducted using an independent t-test and chi-square tests. Multivariable logistic regression models were utilized to examine the risk factors associated with the condition.
Results: Among 318 patients, 140 (44.02%) met thrombocytopenia criteria. The thrombocytopenic cohort had significantly lower (p < 0.05) IQR values for eGFR 57.4 (24.2-94.3), hemoglobin 9.03 (8.04-10.6), hematocrit 28.3 (25.1-33.1), SBP 118 (88.2–146.2), MAP 85 (67.5 – 108), and RR 21.4 (14.3–32.7). Further, the thrombocytopenic cohort had higher IQR values for BUN 28.6 (15.1-53) and SCr 1.1 (0.7-2.5). The thrombocytopenic cohort used less analgesics and sedatives 62 (44.3%, p = 0.03) but more vasopressor agents 34 (10.7, p = 0.001) and experienced longer lengths of stay 70.5 (7.3–890, p = 0.001). The most prescribed medications classes within the thrombocytopenic cohort were IV fluids, anti-infective, and analgesic agents. Medication classes associated with highest thrombocytopenia incidence were vitamins/iron supplements OR 2.12 [1.05-4.32] (0.03), vasopressors 2.95 [1.51-5.92] (0.001), and anti-infectives 1.80 [1.01-3.28] (0.04).
Conclusion: The inclusion of clinical phenotypic and medication use data can improve the identification and risk stratification for the development of thrombocytopenia for adults within the critical care setting.
Presenting Author
Jordan Terrizzi Doctor of Pharmacy CandidateWest Virginia University School of Pharmacy
Authors
Mohammad Al-Mamun Ph.D.
West Virginia University
Todd Brothers PharmD
University of Rhode Island
Marina Galvez-Peralta PharmD, PhD
West Virginia University
Mary Stamatakis PharmD
West Virginia University School of Pharmacy