Lillemäe, K., Luostarinen, T., Reinikainen, M. et al. Early thrombocytopenia is associated with an increased risk of mortality in patients with traumatic brain injury treated in the intensive care unit: a Finnish Intensive Care Consortium study. Acta Neurochir 164, 2731–2740 (2022). https://doi.org/10.1007/s00701-022-05277-9
Early thrombocytopenia is associated with an increased risk of mortality in patients with traumatic brain injury treated in the intensive care unit : a Finnish Intensive Care Consortium study
|Author:||Lillemäe, Kadri1,2; Luostarinen, Teemu3; Reinikainen, Matti4;|
1Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2HUS, Töölö Hospital, Topeliuksenkatu 5, P.B. 266, 00029, Helsinki, Finland
3Anesthesiology and Intensive Care, Hyvinkää Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Anesthesiology and Intensive Care, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
5Department of Perioperative Services, Intensive Care and Pain Management, Turku University Hospital and University of Turku, Turku, Finland
6Department of Intensive Care and Emergency Medicine Services, Tampere University Hospital and Tampere University, Tampere, Finland
7Department of Intensive Care and MRC Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland
8Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
|Online Access:||PDF Full Text (PDF, 0.9 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2023061656022
|Publish Date:|| 2023-06-16
Background: Coagulopathy after traumatic brain injury (TBI) is associated with poor prognosis.
Purpose: To assess the prevalence and association with outcomes of early thrombocytopenia in patients with TBI treated in the intensive care unit (ICU).
Methods: This is a retrospective multicenter study of adult TBI patients admitted to ICUs during 2003–2019. Thrombocytopenia was defined as a platelet count < 100 × 10⁹/L during the first day. The association between thrombocytopenia and hospital and 12-month mortality was tested using multivariable logistic regression, adjusting for markers of injury severity.
Results: Of 4419 patients, 530 (12%) had early thrombocytopenia. In patients with thrombocytopenia, hospital and 12-month mortality were 26% and 48%, respectively; in patients with a platelet count > 100 × 10⁹/L, they were 9% and 22%, respectively. After adjusting for injury severity, a higher platelet count was associated with decreased odds of hospital mortality (OR 0.998 per unit, 95% CI 0.996–0.999) and 12-month mortality (OR 0.998 per unit, 95% CI 0.997–0.999) in patients with moderate-to-severe TBI. Compared to patients with a normal platelet count, patients with thrombocytopenia not receiving platelet transfusion had an increased risk of 12-month mortality (OR 2.2, 95% CI 1.6–3.0), whereas patients with thrombocytopenia receiving platelet transfusion did not (OR 1.0, 95% CI 0.6–1.7).
Conclusions: Early thrombocytopenia occurs in approximately one-tenth of patients with TBI treated in the ICU, and it is an independent risk factor for mortality in patients with moderate-to-severe TBI. Further research is necessary to determine whether this is modifiable by platelet transfusion.
|Pages:||2731 - 2740|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
Open Access funding provided by University of Helsinki including Helsinki University Central Hospital. The study was funded by grants from Finska Läkaresällskapet, Svenska Kulturfonden, and Medicinska Understödsföreningen Liv och Hälsa.
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