J Pediatr Intensive Care 2022; 11(03): 209-214
DOI: 10.1055/s-0040-1722338
Original Article

Thrombocytopenia and Bloodstream Infection: Incidence and Implication on Length of Stay in the Pediatric Intensive Care Unit

1   Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
4   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Dana Levinkopf*
2   Neonatal Intensive Care Unit, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
,
Inna Zaslavsky Paltiel
3   Women and Children's Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research, The Chain Sheba Medical Center, Tel Hashomer, Israel
,
Tal Sadeh
1   Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
,
Marina Rubinstein
1   Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
,
Itai M. Pessach
1   Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
4   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Nathan Keller
5   Tel Aviv University, Sheba Medical Center, Tel Hashomer, Israel
6   Ariel University, Israel
,
Liat Lerner-Geva
3   Women and Children's Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research, The Chain Sheba Medical Center, Tel Hashomer, Israel
7   School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel
,
Gideon Paret
1   Department of Pediatric Intensive Care, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
4   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
› Institutsangaben

Funding None.
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Abstract

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 (p = 0.007). Thrombocytopenia was associated with borderline significance with an increased LOS (adjusted odds ratio = 3.00, 95% confidence interval: 0.93–9.71, p = 0.066). Thrombocytopenia is common in critically ill pediatric patients with BSI and constitutes a simple and readily available risk marker for PICU LOS.

* These authors contributed equally to this work.




Publikationsverlauf

Eingereicht: 24. Oktober 2020

Angenommen: 26. November 2020

Artikel online veröffentlicht:
20. Januar 2021

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