We conducted a retrospective chart review of 193 patients admitted during a 3-month period to determine the frequency of and potential risk factors associated with
thrombocytopenia, and the association of acquired
thrombocytopenia with
length of stay in a surgical-
trauma intensive care unit (SICU) and mortality. All records were reviewed beginning 24 hours after admission. Patients were followed for the duration of SICU stay or until death. Data collected and analyzed as potential risk factors for
thrombocytopenia were age, gender, admitting diagnosis, classification (
trauma, surgical, medical), APACHE II score, medical history, all scheduled drugs with start and stop dates, select laboratory values, arterial or central line placement, and complications.
Thrombocytopenia occurred in 25 (13%) patients. These patients were more likely (p<0.05) than those without
thrombocytopenia to have the following potential risk factors: presence of a central or
arterial line (76% vs 46%, p<0.025), nonsurgical diagnosis (60% vs 37%, p<0.05), diagnosis of
sepsis (p<0.001), and administration of
phenytoin (p<0.01),
piperacillin (p<0.005),
imipenem-cilastatin (p<0.001), and
vancomycin (p<0.005). A longer SICU stay (mean 21 vs 4.5 days, p<0.05) and increased mortality (16% vs 4%, p<0.05) were significantly associated with
thrombocytopenia.
Cefazolin administration was significantly associated with nonthrombocytopenia (p<0.05). Factors not associated with
thrombocytopenia were age, gender, and administration of histamine2-receptor
antagonists, heparin,
enoxaparin,
penicillins,
ceftazidime,
ceftriaxone,
chloramphenicol, and
amphotericin B. A central or
arterial line was the only factor associated with the development of
thrombocytopenia in a multiple linear regression analysis (p=0.0003, multiple r=0.2580).
Thrombocytopenia is not a common occurrence in the SICU, but is associated with a longer SICU stay and increased mortality.