Purpose: Thrombocytopenia (platelet count <150×103/μL) is associated with poor outcomes in various critical illness settings. However, the prognostic value of platelet count in patients with cardiogenic shock (CS) remains unclear. Materials and Methods: We enrolled 1202 patients between January 2014 and December 2018 from a multicenter retrospective– prospective cohort registry of CS. Clinical characteristics and treatment outcomes were compared between the patients with and without thrombocytopenia. Results: At presentation with CS, 244 (20.3%) patients had thrombocytopenia. The patients with thrombocytopenia had lower blood pressure, hemoglobin level, and worse liver and renal functions compared to the patients without. During hospitalization, the patients with thrombocytopenia had more frequent gastrointestinal bleeding (10.5% vs. 3.8%, p=0.009), sepsis (8.3% vs. 2.6%, p=0.013), requirement of renal replacement therapy (36.5% vs. 18.9%, p<0.001), requirement of mechanical ventilation (65.2% vs. 54.4%, p=0.003), longer intensive care unit stay (8 days vs. 4 days, p<0.001), and thirty-day mortality (40.2% vs. 28.5%, p<0.001) compared to those without. In addition, the platelet count was an independent predictor of 30-day mortality (per 103/µL decrease; adjusted hazard ratio: 1.002, 95% confidence interval: 1.000–1.003, p=0.021). Conclusion: Thrombocytopenia at CS presentation was associated with worse clinical findings, higher frequencies of complications, and longer stay at the intensive care unit. Also, thrombocytopenia was independently associated with increased 30-day mortality. (Clinical trial registration No. NCT02985008).
Bibliographical noteFunding Information:
This work was supported by the Korea Health Technology Research & Development Project [grant nos. HI17C0882, HI16 C2211, and HI15C2782] through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea; the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government [grant no. 2015M3A9C6031514]; and the Cardiovascular Research Center, Seoul, Republic of Korea.
H.L. was supported by the Physician-Scientist Fellowship Program, Yonsei University College of Medicine, Seoul, Republic of Korea.
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