Kassif Lerner Reut, Levinkopf Dana, Zaslavsky Paltiel Inna, Sadeh Tal, Rubinstein Marina, Pessach Itai M, Keller Nathan, Lerner-Geva Liat, Paret Gideon
Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Pediatr Intensive Care. 2021 Jan 20;11(3):209-214. doi: 10.1055/s-0040-1722338. eCollection 2022 Sep.
The incidence and prognosis of thrombocytopenia in critically ill patients with bloodstream infection (BSI) is not well delineated in the pediatric intensive care unit (PICU) setting. We assessed these variables in our PICU and sought to determine whether thrombocytopenia could serve as a prognostic marker for length of stay (LOS). The study was conducted at the medical PICU of a university hospital, on all critically ill pediatric patients consecutively admitted during a 3-year period. Patient surveillance and data collection have been used to identify the risk factors during the study period. The main outcomes were BSI incidence and implication on morbidity and LOS. Data from 2,349 PICU patients was analyzed. The overall incidence of BSI was 3.9% (93/2,349). Overall, 85 of 93 patients (91.4%) with BSI survived and 8 patients died (8.6% mortality rate). The overall incidence of thrombocytopenia among these 93 patients was 54.8% (51/93) and 100% (8/8) for the nonsurvivors. Out of the 85 survivors, 27 thrombocytopenic patients were hospitalized for >14 days versus 14 of nonthrombocytopenic patients ( = 0.007). Thrombocytopenia was associated with borderline significance with an increased LOS (adjusted odds ratio = 3.00, 95% confidence interval: 0.93-9.71, = 0.066). Thrombocytopenia is common in critically ill pediatric patients with BSI and constitutes a simple and readily available risk marker for PICU LOS.
在儿科重症监护病房（PICU）环境中，血流感染（BSI）的重症患者血小板减少症的发病率和预后尚未得到明确界定。我们在我们的PICU中评估了这些变量，并试图确定血小板减少症是否可以作为住院时间（LOS）的预后标志物。该研究在一家大学医院的医学PICU进行，研究对象为3年期间连续收治的所有重症儿科患者。在研究期间，通过患者监测和数据收集来确定风险因素。主要结局是BSI发病率及其对发病率和住院时间的影响。对2349例PICU患者的数据进行了分析。BSI的总体发病率为3.9%（93/2349）。总体而言，93例BSI患者中有85例（91.4%）存活，8例死亡（死亡率8.6%）。这93例患者中血小板减少症的总体发病率为54.8%（51/93），非幸存者的发病率为100%（8/8）。在85名幸存者中，27名血小板减少症患者住院时间>14天，而非血小板减少症患者为14名（P = 0.007）。血小板减少症与住院时间延长具有临界显著性相关（调整后的优势比=3.00，95%置信区间：0.93 - 9.71，P = 0.066）。血小板减少症在患有BSI的重症儿科患者中很常见，并且是PICU住院时间简单且易于获得的风险标志物。
