Abstract：
BACKGROUND: Thrombocytopenia is common for patients in the intensive care unit (ICU) and is associated with adverse outcomes. ICU thrombocytopenia in pediatric patients who underwent cardiac surgeries with cardiopulmonary bypass (CPB) is inadequately studied.
OBJECTIVE: We aimed to investigate the incidence, risk factors, and prognostic role of ICU thrombocytopenia after congenital cardiac surgeries with CPB.
METHODS: A retrospective study involving 11761 patients was conducted. Patients were categorized into four groups of thrombocytopenia based on platelet counts tested during ICU: non (> 150×109/L), mild (100-150×109/L), moderate (50-100×109/L), and severe (< 50×109/L). Logistic and Cox regression analyses were utilized to explore the risk factors of thrombocytopenia and the association of ICU thrombocytopenia with 30-day mortality.
RESULTS: ICU thrombocytopenia was observed in 4007 patients (34.1%), with mild, moderate, and severe thrombocytopenia occurring in 2773 (23.6%), 987 (8.4%), and 247 (2.1%) patients, respectively. Younger age, cyanotic CHD, CPB duration, and preoperative laboratory findings (red blood cell, thrombocytopenia, red cell distribution width, hematocrit, coagulation disorder) were identified as independent risk factors of ICU thrombocytopenia. Patients with moderate [HR: 11.38 (3.02-42.87), p<0.001] and severe thrombocytopenia [HR: 49.54 (13.11-187.14), p<0.001] had a significantly higher risk of 30-day mortality. Furthermore, with the increase in the severity of ICU thrombocytopenia, there was an incremental increase in the incidence of postoperative critical bleeding and thrombosis, perioperative blood transfusions, length of ICU stays, and duration of mechanical ventilation.
CONCLUSIONS: ICU thrombocytopenia occurred in one-third of children after congenital cardiac surgery with CPB, and it was associated with multiple adverse outcomes.
OBJECTIVE: We aimed to investigate the incidence, risk factors, and prognostic role of ICU thrombocytopenia after congenital cardiac surgeries with CPB.
METHODS: A retrospective study involving 11761 patients was conducted. Patients were categorized into four groups of thrombocytopenia based on platelet counts tested during ICU: non (> 150×109/L), mild (100-150×109/L), moderate (50-100×109/L), and severe (< 50×109/L). Logistic and Cox regression analyses were utilized to explore the risk factors of thrombocytopenia and the association of ICU thrombocytopenia with 30-day mortality.
RESULTS: ICU thrombocytopenia was observed in 4007 patients (34.1%), with mild, moderate, and severe thrombocytopenia occurring in 2773 (23.6%), 987 (8.4%), and 247 (2.1%) patients, respectively. Younger age, cyanotic CHD, CPB duration, and preoperative laboratory findings (red blood cell, thrombocytopenia, red cell distribution width, hematocrit, coagulation disorder) were identified as independent risk factors of ICU thrombocytopenia. Patients with moderate [HR: 11.38 (3.02-42.87), p<0.001] and severe thrombocytopenia [HR: 49.54 (13.11-187.14), p<0.001] had a significantly higher risk of 30-day mortality. Furthermore, with the increase in the severity of ICU thrombocytopenia, there was an incremental increase in the incidence of postoperative critical bleeding and thrombosis, perioperative blood transfusions, length of ICU stays, and duration of mechanical ventilation.
CONCLUSIONS: ICU thrombocytopenia occurred in one-third of children after congenital cardiac surgery with CPB, and it was associated with multiple adverse outcomes.
摘要：
背景：血小板减少在重症监护病房（ICU）的患者中很常见，并且与不良结局相关。对接受体外循环（CPB）心脏手术的儿科患者的ICU血小板减少症的研究不足。
目的：我们旨在调查发病率，危险因素，先天性心脏病CPB术后ICU血小板减少的预后作用。
方法：进行了一项涉及11761例患者的回顾性研究。根据ICU期间检测的血小板计数，将患者分为四组血小板减少症：非（>150×109/L），轻度(100-150×109/L),中等（50-100×109/L），严重（<50×109/L）。Logistic和Cox回归分析用于探讨血小板减少症的危险因素以及ICU血小板减少症与30天死亡率的关系。
结果：在4007例患者中观察到ICU血小板减少症（34.1％），温和，中度,和严重的血小板减少症发生在2773（23.6％），987（8.4%），247名(2.1%)患者，分别。年龄更小,紫红色CHD,CPB持续时间,和术前实验室检查结果(红细胞，血小板减少症,红细胞分布宽度，血细胞比容,凝血障碍）被确定为ICU血小板减少症的独立危险因素。中度患者[HR：11.38（3.02-42.87），p<0.001和严重的血小板减少症[HR：49.54（13.11-187.14），p<0.001]具有显著更高的30天死亡风险。此外，随着ICU血小板减少症严重程度的增加，术后严重出血和血栓形成的发生率逐渐增加，围手术期输血,ICU停留时间的长度,和机械通气的持续时间。
结论：1/3的儿童先天性心脏手术后发生ICU血小板减少，并且与多种不良结局相关.
目的：我们旨在调查发病率，危险因素，先天性心脏病CPB术后ICU血小板减少的预后作用。
方法：进行了一项涉及11761例患者的回顾性研究。根据ICU期间检测的血小板计数，将患者分为四组血小板减少症：非（>150×109/L），轻度(100-150×109/L),中等（50-100×109/L），严重（<50×109/L）。Logistic和Cox回归分析用于探讨血小板减少症的危险因素以及ICU血小板减少症与30天死亡率的关系。
结果：在4007例患者中观察到ICU血小板减少症（34.1％），温和，中度,和严重的血小板减少症发生在2773（23.6％），987（8.4%），247名(2.1%)患者，分别。年龄更小,紫红色CHD,CPB持续时间,和术前实验室检查结果(红细胞，血小板减少症,红细胞分布宽度，血细胞比容,凝血障碍）被确定为ICU血小板减少症的独立危险因素。中度患者[HR：11.38（3.02-42.87），p<0.001和严重的血小板减少症[HR：49.54（13.11-187.14），p<0.001]具有显著更高的30天死亡风险。此外，随着ICU血小板减少症严重程度的增加，术后严重出血和血栓形成的发生率逐渐增加，围手术期输血,ICU停留时间的长度,和机械通气的持续时间。
结论：1/3的儿童先天性心脏手术后发生ICU血小板减少，并且与多种不良结局相关.
