%0 Journal Article
%T Thrombocytopenia Developed in Intensive Care Unit for Congenital Heart Disease: Incidence, Risk Factors, and Outcomes.
%A Shen H
%A He Q
%A Li W
%A Zhu G
%A Wang X
%A Liu J
%A Zhang Y
%A Li S
%A Zhou Z
%J J Thromb Haemost
%V 0
%N 0
%D 2024 Jun 20
%M 38908831
%F 16.036
%R 10.1016/j.jtha.2024.05.036
%X <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>We aimed to investigate the incidence, risk factors, and prognostic role of ICU thrombocytopenia after congenital cardiac surgeries with CPB.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>ICU thrombocytopenia occurred in one-third of children after congenital cardiac surgery with CPB, and it was associated with multiple adverse outcomes.