Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia

SummaryObjectiveTo evaluate the prevalence and the prognostic value of thrombocytopenia in patients admitted to ICU for severe community-acquired pneumonia.MethodsMulticentre observational study was conducted in 7 ICUs in the north of France over a 19-year period (1987–2005). The primary outcome measure was the ICU mortality.ResultsEight hundred and twenty-two patients were studied. A platelet count <150 × 109/L was observed at ICU admission in 202 (25%) patients. Admission platelet count was between 101 and 149 × 109/L, 51 and 100 × 109/L, 21 and 50 × 109/L, and ≤20 × 109/L in 100, 61, 32 and 9 patients, respectively. ICU mortality rate was 35.4%. Classifying patients into 3 categories with the following cut-offs of platelet count, ≥150 × 109/L, 51–149 × 109/L, and ≤50 × 109/L, we observed a significant increase in ICU mortality rates which were 30.8% in the first group, 44.1% in the second group and 70.7% in the last one (p < 0.0001). In multivariate analysis, thrombocytopenia ≤50 × 109/L appeared as an independent predictor of mortality (AOR = 4.386).ConclusionsIn patients admitted to ICU for severe community-acquired pneumonia, thrombocytopenia has a high prevalence and influences the outcome.