Effects of Platelet Transfusion on Sepsis Associated Thrombocytopenia (SAT): A Multicenter Retrospective Chart Review

Abstract

Objective

To investigate effects of platelet transfusion on sepsis associated thrombocytopenia (SAT).

Methods

In this study, 695 SAT patients admitted to Peking Union Medical College Hospital (PUMCH) were enrolled from June 8, 2013 to October 12, 2022. Externally validate was carried out using 2739 SAT patients in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into 2 groups based on whether platelet transfusion was administered.

Results

After propensity score-matching, compared with the control group, the platelet transfusion group had longer mechanical ventilation time (43 vs 169 h, P < 0.05), more expenses (122.29 vs 254.03 thousand yuan [RMB], P < 0.05), longer hospital stays (536 vs 817 h, P < 0.05), longer hospital stays after diagnosis of SAT (384 vs 636 h, P < 0.05), longer ICU stays (133 vs 227 h, P < 0.05), higher mortality (30.1 vs 53.4%, P < 0.05). Effective platelet transfusion rate was 52.51%. Subgroup analysis based on the degree of thrombocytopenia and data analysis from MIMIC-IV further confirmed above results. Contrary to intuition, as the platelet count decreased, the effective platelet transfusion rate tended to decrease. Positive rate of deep vein thrombosis (DVT) was 18.85% in SAT in PUMCH. Compared with the control group, the platelet transfusion group had higher positive rate of DVT (27 / 131 vs 33 / 92, P < 0.05) in subgroup with platelet count [50, 100 × 10⁹/L) in PUMCH.

Conclusions

No benefits from platelet transfusion were observed in SAT. Around 50% of platelet transfusions in SAT were platelet transfusion refractoriness. Platelet transfusion was associated with higher positive rate of DVT in SAT patients with platelet count [50, 100 × 10⁹/L).