| Title |
Risks of bleeding and thrombosis in intensive care unit patients with haematological malignancies
|
|---|---|
| Published in |
Annals of Intensive Care, December 2017
|
| DOI | 10.1186/s13613-017-0341-y |
| Pubmed ID | |
| Authors |
Lene Russell, Lars Broksø Holst, Lars Kjeldsen, Jakob Stensballe, Anders Perner |
| Abstract |
Patients with malignant haematological disease and especially those who require intensive care have an increased risk of bleeding and thrombosis, but none of these data were obtained in ICU patients only. We assessed the incidence of bleeding and thrombotic complications, use of blood products and risk factors for bleeding in an adult population of ICU patients with haematological malignancies. We screened all patients with acute leukaemia and myelodysplastic syndrome admitted to a university hospital ICU during 2008-2012. Bleeding in ICU was scored according to the WHO grading system, and risk factors were evaluated using unadjusted and adjusted analyses. In total, 116 of 129 ICU patients were included; their median length of stay was 7 (IQR 2-16) days. Of these, 66 patients (57%) had at least one bleeding episode in ICU; they bled for 3 (2-6) days and most often from lower and upper airways and upper GI tract. Thirty-nine (59%) of the 66 patients had severe or debilitating (WHO grade 3 or 4) bleeding. The median platelet count on the day of grade 3 or 4 bleeding was 23 × 109 per litre (IQR 13-39). Nine patients (8%) died in ICU following a bleeding episode; five of these had intra-cerebral haemorrhage. Platelet count on admission was associated with subsequent bleeding (adjusted odds ratio 1.18 (95% CI 1.03-1.35) for every 10 × 109 per litre drop in platelet count, p = 0.016). Eleven of the 116 patients (9%) developed a clinically significant thrombosis in ICU, which was the cause of death in four patients. The median platelet count was 20 × 109 per litre (15-48) at the time of thrombosis. The patients received a median of 6 units of red blood cells, 1 unit of fresh frozen plasma and 8 units of platelet concentrates in ICU. Severe and debilitating bleeding complications were frequent in our ICU patients with haematological malignancies, but thrombosis also occurred in spite of low platelet counts. Platelet count on ICU admission was associated with subsequent bleeding. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Denmark | 2 | 67% |
| France | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 67% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 9 | 19% |
| Student > Ph. D. Student | 7 | 15% |
| Student > Postgraduate | 5 | 11% |
| Other | 4 | 9% |
| Researcher | 3 | 6% |
| Other | 6 | 13% |
| Unknown | 13 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 53% |
| Engineering | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Unspecified | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 15 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 February 2018.
All research outputs
#14,086,689
of 23,011,300 outputs
Outputs from Annals of Intensive Care
#744
of 1,052 outputs
Outputs of similar age
#230,029
of 439,919 outputs
Outputs of similar age from Annals of Intensive Care
#17
of 20 outputs
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