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Clinical Implications of Thrombocytopenia at Cardiogenic Shock Presentation: Data from a Multicenter Registry

Authors
 Hyeok Hee Lee  ;  Sung Jin Hong  ;  Chul Min Ahn  ;  Jeong Hoon Yang  ;  Hyeon Cheol Gwon  ;  Jung Sun Kim  ;  Byeong Keuk Kim  ;  Young Guk Ko  ;  Donghoon Choi  ;  Myeong Ki Hong  ;  Yangsoo Jang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.61(10) : 851-859, 2020-10 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2020-10
MeSH
Adult ; Aged ; Case-Control Studies ; Cohort Studies ; Critical Illness ; Female ; Gastrointestinal Hemorrhage / epidemiology ; Humans ; Intensive Care Units / statistics & numerical data* ; Length of Stay / statistics & numerical data* ; Male ; Middle Aged ; Multicenter Studies as Topic ; Platelet Count ; Prevalence ; Prognosis ; Prospective Studies ; Registries / statistics & numerical data* ; Respiration, Artificial / statistics & numerical data ; Retrospective Studies ; Sepsis / blood ; Sepsis / epidemiology ; Shock, Cardiogenic* / diagnosis ; Shock, Cardiogenic* / mortality ; Shock, Cardiogenic* / therapy ; Thrombocytopenia* / diagnosis ; Thrombocytopenia* / mortality ; Thrombocytopenia* / therapy ; Treatment Outcome
Keywords
Cardiogenic shock ; mortality ; platelet ; prognosis ; thrombocytopenia
Abstract
Purpose: Thrombocytopenia (platelet count <150×10³/μL) is associated with poor outcomes in various critical illness settings. However, the prognostic value of platelet count in patients with cardiogenic shock (CS) remains unclear. Materials and methods: We enrolled 1202 patients between January 2014 and December 2018 from a multicenter retrospective-prospective cohort registry of CS. Clinical characteristics and treatment outcomes were compared between the patients with and without thrombocytopenia. Results: At presentation with CS, 244 (20.3%) patients had thrombocytopenia. The patients with thrombocytopenia had lower blood pressure, hemoglobin level, and worse liver and renal functions compared to the patients without. During hospitalization, the patients with thrombocytopenia had more frequent gastrointestinal bleeding (10.5% vs. 3.8%, p=0.009), sepsis (8.3% vs. 2.6%, p=0.013), requirement of renal replacement therapy (36.5% vs. 18.9%, p<0.001), requirement of mechanical ventilation (65.2% vs. 54.4%, p=0.003), longer intensive care unit stay (8 days vs. 4 days, p<0.001), and thirty-day mortality (40.2% vs. 28.5%, p<0.001) compared to those without. In addition, the platelet count was an independent predictor of 30-day mortality (per 103/μL decrease; adjusted hazard ratio: 1.002, 95% confidence interval: 1.000-1.003, p=0.021). Conclusion: Thrombocytopenia at CS presentation was associated with worse clinical findings, higher frequencies of complications, and longer stay at the intensive care unit. Also, thrombocytopenia was independently associated with increased 30-day mortality. (Clinical trial registration No. NCT02985008).
Files in This Item:
T202004335.pdf Download
DOI
10.3349/ymj.2020.61.10.851
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180219
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