Hemodynamics, fluids & transfusion
Platelet Transfusion Practices in the ICU: A Prospective Multicenter Cohort Study
Authors' conclusion
Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.
Study context
- Population
- Adults ≥18 y admitted to the ICU during a single study week (March 2019 to October 2022), 233 centres in 30 countries
- Participants
- 3,643 adults · 233 centres · 30 countries
- Exposure
- High-income countries vs Upper-middle-income countries vs Lower-middle-income countries
- High-income countriesn = 2,520
- Upper-middle-income countriesn = 1,069
- Lower-middle-income countriesn = 54
- Outcome
- Occurrence rate of platelet transfusion in the ICU
- Follow-up
- During ICU stay
Methodological detailsinternational, multicentre
- International
- Multicentre
Main finding
As reported in the abstract
Patients receiving a platelet transfusion during ICU stay, of 3643
208
6%
Observational data: associations, not effects.
Further findings
| Outcome | High-income countries | Upper-middle-income countries | Lower-middle-income countries |
|---|---|---|---|
| Platelet transfusion rate by geo-economic region | 6% | 5% | 0 events |
| Non-adherence to threshold by geo-economic region | 23% | 3% | — not stated in the abstract |
— not stated in the abstract
- Platelet transfusion rate by geo-economic region: n = 156/2520; n = 52/1069; n = 0/54
- Non-adherence to threshold by geo-economic region: n = 34/149; n = 2/75
Main indications for platelet transfusion (of 443 events)
- Active bleeding
- 42%, n = 187/443
- Prophylaxis
- 33%, n = 144/443
- Upcoming procedure
- 12%, n = 51/443
Platelet count before transfusion
- Median platelet count before transfusion, all events (× 10 9 /L)
- 44 (IQR, 20-78)
- Median platelet count before transfusion, active bleeding (× 10 9 /L)
- 60 (IQR 31-93)
- Varied by indication
Transfusion threshold stated
- Events with a stated threshold
- 51% ( n = 224/443)
- Median threshold platelet count (× 10 9 /L)
- 50 (IQR, 40-100)
Non-adherence to advised threshold
- Advised threshold not adhered to (majority with active bleeding as indication)
- 16% ( n = 36/224)
Original publication
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