Hemodynamics, fluids & transfusion
Prophylactic versus restrictive platelet transfusion strategy in patients with haematological malignancies in the ICU setting, a propensity-score analysis
Main finding · Platelet transfusions, incidence rate for 100 ICU patient-daysResult — go to the resultIncidence rate ratio 0.699 CI 0.5–0.9Authors' conclusion
A restrictive PT strategy appears feasible in the ICU.
Study context
- Population
- Adults with haematological malignancy admitted to the ICU with thrombocytopenia <20 G/L, 2018–20212 × 54 matched analysed
- Participants
- 180 adults
- Exposure
- Restrictive vs Prophylactic
- Restrictiven = 87
- Prophylacticn = 93reference
- Outcome
- Platelet transfusions (incidence rate per 100 ICU patient-days)
Methodological detailssingle-centre, propensity-score matched
- Single-centre
- Propensity-score matched
Main finding
As reported in the abstract
Platelet transfusions, incidence rate for 100 ICU patient-days
Incidence rate ratio
0.699
CI 0.5–0.9
P = 0.006
By group
Restrictive
34.9
Prophylactic
49.9
Restrictive vs Prophylactic
IRR 0.699 (CI 0.5–0.9); P = 0.006
Observational data: associations, not effects.
Further findings
| Outcome | Restrictive | Prophylactic | P value |
|---|---|---|---|
| Platelet concentrate transfusion-free days · day 28 | 21 (interval 13–25) | 16.5 (interval 10.2–21) | P = 0.04 |
Days with platelet <10 or <20 G/L
- Similar number of days regardless of strategy; transfusion efficiency low
28-day mortality
- Platelet nadir <5G/L associated with day-28 mortality, HR
- 1.882 [1.011-3.055], p = 0.046
- Platelet transfusion strategy not associated with 28-day mortality
Safety
- Restrictive strategy did not result in higher grade ≥ 2 bleeding
Original publication
Prophylactic versus restrictive platelet transfusion strategy in patients with haematological malignancies in the ICU setting, a propensity-score analysis. J Crit Care. Published 27 May 2024. doi:10.
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