PB0658 - Risk Factors of Thrombocytopenia in Intensive Care Unit and Its Association with Adverse Outcomes after Pediatric Congenital Cardiac Surgeries with Cardiopulmonary Bypass

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Huayan Shen

Graduate student
Center of Laboratory Medicine, State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China.
Beijing, Beijing, China (People's Republic)

Co-Author(s)

ZZ

Zhou Zhou

Professor
Department of Laboratory Medicine, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
Beijing, Beijing, China (People's Republic)
YZ

Yang Zhang

Professor
Department of Laboratory Medicine, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
Beijing, Beijing, China (People's Republic)

Background: Thrombocytopenia is common for patients in the intensive care unit (ICU) and is associated with adverse outcomes. ICU thrombocytopenia in pediatric patients undergoing cardiac surgeries with cardiopulmonary bypass (CPB) is seldom reported.

Aims: To explore the risk factors of ICU thrombocytopenia and its association with adverse outcomes after pediatric congenital cardiac surgeries with CPB.

Methods: A retrospective study involving 11,761 pediatric patients was conducted. The continuous platelet test results within 7 days of ICU admission and the complete preoperative biochemical and hematological laboratory results were collected. ICU thrombocytopenia was classified into three levels: mild (100-150×109/L), moderate (50-100×109/L), and severe ( < 50×109/L), and patients were grouped according to their most severe grade of thrombocytopenia. The logistic regression analysis was used to identify risk factors for ICU thrombocytopenia and its association with adverse outcomes.

Results: The median age of the patients was 1.7 (0.7-3.7) years, and 51.5% of them were male. A total of 4007 (34.1%) patients developed ICU thrombocytopenia, of which 2773 (23.6%) had mild thrombocytopenia, 987 (8.4%) had moderate thrombocytopenia, and 247 (2.1%) had severe thrombocytopenia. The main factors associated with the occurrence of ICU thrombocytopenia were age, cyanotic CHD (congenital heart disease), CPB duration, preoperative thrombocytopenia, and other factors (Table 1). Patients with moderate or severe ICU thrombocytopenia exhibited a significantly higher risk of in-hospital death and composite adverse events when compared to those without thrombocytopenia. Additionally, ICU thrombocytopenia of any severity was significantly associated with prolonged postoperative mechanical ventilation and ICU stay (Table 2).

Conclusion(s): More than 30% of pediatric CHD patients who underwent cardiac surgeries with CPB developed ICU thrombocytopenia. ICU thrombocytopenia was significantly associated with postoperative adverse outcomes, and the risk escalated with the severity of thrombocytopenia.