Background
Methods
Patients and study design
Clinical data
Transfusion data
Microbiological data
Statistical analysis
Results
Patient characteristics
Variables | All patients N = 18,965 | Patients with PLT transfusion N = 2250 | Patients without PLT transfusion N = 16,715 |
P value |
---|---|---|---|---|
Age, years, mean (SD) | 60 (18) | 59 (17) | 60 (17) | 0.04 |
Gender, male, n (%) | 12 086 (63.7%) | 1 511 (67.2%) | 10 575 (63.3%) | <0.01 |
APACHE III score, mean (SD) | 54 (26) | 65 (29) | 52 (25) | <0.01 |
Comorbidities
| ||||
Any known comorbidity | 3 838 (20%) | 702 (31%) | 3 136 (19%) | <0.01 |
Cancera
| 857 (4.5%) | 192 (8.5%) | 665 (4.0%) | <0.01 |
Hepatic diseaseb
| 674 (3.6%) | 216 (9.6%) | 458 (2.7%) | <0.01 |
Immunocompromisedc
| 1 180 (6.2%) | 311 (13.8%) | 869 (5.2%) | <0.01 |
IDDM | 511 (2.7%) | 60 (2.7%) | 451 (2.7%) | 0.93 |
Chronic respiratory disease | 840 (4.4%) | 92 (4.1%) | 748 (4.5%) | 0.40 |
CVD | 754 (4%) | 137 (6.1%) | 617 (3.7%) | <0.01 |
Chronic renal failure | 422 (2%) | 59 (2.6%) | 363 (2.2%) | 0.17 |
Admission diagnosis | ||||
Cardiovascular | 5 161 (27%) | 701 (31%) | 4 460 (27%) | <0.01 |
Gastrointestinal | 3 595 (19%) | 581 (26%) | 3 014 (18%) | <0.01 |
Haematological | 152 (0.8%) | 96 (4.3%) | 56 (0.3%) | <0.01 |
Neurological | 1 586 (8.4%) | 108 (4.8%) | 1 478 (8.8%) | <0.01 |
Renal/genitourinary | 1 017 (5.4%) | 108 (4.8%) | 909 (5.4%) | 0.2 |
Respiratory | 1 467 (7.7%) | 127 (5.6%) | 1 340 (8%) | <0.01 |
Sepsis | 503 (2.7%) | 73 (3.2%) | 430 (2.6%) | 0.06 |
Otherd
| 2 815 (14.8%) | 82 (3.6%) | 2 733 (16.4%) | <0.01 |
Trauma | 2 669 (14.1%) | 374 (16.6%) | 2 295 (13.7%) | <0.01 |
Requirement for MV | 11 531 (61%) | 1 952 (87%) | 9 579 (57%) | <0.01 |
Requirement for RRT | 1 135 (6%) | 449 (20%) | 686 (4%) | <0.01 |
Transfusion characteristics
PLT transfusion and infections
Variables | All patients N = 18,965 | Patients with PLT transfusion N = 2250 | Patients without PLT transfusion N = 16,715 |
P value* |
---|---|---|---|---|
Infections, n (%) Any (blood or urine culture) Blood culture Urine culture | 411 (2.2) 178 (0.9) 262 (1.4) | 173 (7.7) 99 (4.4) 89 (4) | 238 (1.4) 79 (0.5) 173 (1) | <0.01 < 0.01 < 0.01 |
Time to infection, days median (IQR) Any (blood or urine) Blood culture Urine culture | 7.1 (4.2–12) 7.9 (4.5–12) 6.8 (4.1–11.7) | 8.9 (5.1–15.0) 8.4 (5–14) 9.1 (5.2–17) | 6.4 (3.9–10) 6.6 (4.3–12) 6.3 (3.8–10.1) | <0.01 < 0.01 0.25 |
Pathogens | Patients with positive UC N = 292 | Patients with positive UC and with PLT transfusion N = 99 | Patients with positive UC without PLT transfusion N = 193 |
P value |
---|---|---|---|---|
Enterobactericeae Enterococcus
| 17 (5.8%) | 43 (43.4%) | 108 (56%) | 0.04 |
Staphylococcus sp. | 38 (19.5%) | 2 (2%) | 15 (7.8%) | 0.04 |
Candida sp. | 7 (2.4%) | 3 (3%) | 4 (2.1%) | 0.44 |
Non-fermentive GNB | 90 (30.8%) | 44 (44.4%) | 46 (23.8%) | < 0.01 |
Other | 30 (10.3%) | 9 (9.1%) | 21 (10.9%) | 0.63 |
2 (0.7%) | 1 (1%) | 1 (0.5%) | 0.56 | |
UC with >1 microorganism | 25 (8.6%) | 5 (5.1%) | 20 (10.4%) | 0.12 |
Pathogens | Patients with positive blood culture N = 195 | Patients with positive blood culture who had PLT transfusion N = 108 | Patients with positive blood culture without PLT transfusion N = 87 |
P value |
---|---|---|---|---|
Enterobactericeae | 54 (27.7%) | 28 (26%) | 26 (29%) | 0.54 |
Enterococcus
| 38 (19.5%) | 27 (25%) | 11 (13%) | 0.03 |
Staphylococcus aureus
| 20 (10.3%) | 9 (8.3%) | 11 (12.6%) | <0.01 |
CNS | 39 (20%) | 21 (19.4%) | 18 (20.7%) | 0.83 |
Candida | 36 (18.5%) | 26 (24.1%) | 10 (11.5%) | 0.02 |
Non-fermentive GNB | 16 (8.2%) | 7 (6.5%) | 9 (10.3%) | 0.33 |
Other | 2 (1%) | 1 (0.9%) | 1 (1.2%) | 0.88 |
BC with >1 microorganism | 14 (7.2%) | 9 (8.3%) | 5 (5.8%) | 0.49 |
Variablesa
| Adjusted odds ratio* | 95% Confidence interval |
P value |
---|---|---|---|
PLT | 2.56 | 1.98-3.31 | <0.01 |
Gender, male | 0.40 | 0.33-0.50 | <0.01 |
APACHE III score | 1.01 | 1.00-1.01 | <0.01 |
RBC transfusionb
| 1.50 | 1.19-1.90 | <0.01 |
FFP transfusionb
| 0.92 | 0.68-1.24 | 0.57 |
Cryoprecipitateb
| 1.14 | 0.75-1.73 | 0.53 |
Invasive mechanical ventilation | 3.16 | 2.29-4.36 | <0.01 |
RRT | 4.75 | 3.56-6.32 | <0.01 |
Variablesa
| Adjusted hazard ratio | 95% Confidence interval |
P value |
---|---|---|---|
PLT transfusion | 1.85 | 1.41-2.41 | <0.01 |
Gender | 0.43 | 0.35-0.52 | <0.01 |
APACHE III score | 1.00 | 1.00-1.01 | 0.20 |
RBCb
| 1.02 | 0.79-1.33 | 0.86 |
FFPb
| 0.87 | 0.66-1.14 | 0.32 |
Cryoprecipitateb
| 1.01 | 0.74-1.40 | 0.94 |
Invasive mechanical ventilation | 0.77 | 0.57-1.06 | 0.11 |
RRT | 1.33 | 1.03-1.71 | 0.03 |