Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia

Objective: To evaluate the prevalence and the prognostic value of thrombocytopenia in patients admitted to ICU for severe community-acquired pneumonia. Methods: Multicentre observational study was conducted in 7 ICUs in the north of France over a 19-year period (1987-2005). The primary outcome measure was the ICU mortality. Results: Eight hundred and twenty-two patients were studied. A platelet count <150 x 10(9)/L was observed at ICU admission in 202 (25%) patients. Admission platelet count was between 101 and 149 x 10(9)/L, 51 and 100 x 10(9)/L, 21 and 50 x 10(9)/L, and <= 20 x 10(9)/L in 100, 61, 32 and 9 patients, respectively. ICU mortality rate was 35.4%. Classifying patients into 3 categories with the following cut-offs of platelet count, >= 150 x 10(9)/L, 51-149 x 10(9)/L, and <= 50 x 10(9)/L, we observed a significant increase in ICU mortality rates which were 30.8% in the first group, 44.1% in the second group and 70.7% in the last one (p < 0.0001). In muttivariate analysis, thrombocytopenia <= 50 x 10(9)/L appeared as an independent predictor of mortality (AOR = 4.386). Conclusions: In patients admitted to ICU for severe community-acquired pneumonia, thrombocytopenia has a high prevalence and influences the outcome. (c) 2007 The British Infection Society. Published by Elsevier Ltd. All rights reserved.