Predictive value of thrombocytopenia for bloodstream infection in patients with sepsis and septic shock

World J Crit Care Med. 2024 Mar 9;13(1):88540. doi: 10.5492/wjccm.v13.i1.88540.

Abstract

Background: Thrombocytopenia is common in patients with sepsis and septic shock.

Aim: To analyse the decrease in the number of platelets for predicting bloodstream infection in patients with sepsis and septic shock in the intensive care unit.

Methods: A retrospective analysis of patients admitted with sepsis and septic shock in Xingtai People Hospital was revisited. Patient population characteristics and laboratory data were collected for analysis.

Results: The study group consisted of 85 (39%) inpatients with bloodstream infection, and the control group consisted of 133 (61%) with negative results or contamination. The percentage decline in platelet counts (PPCs) in patients positive for pathogens [57.1 (41.3-74.6)] was distinctly higher than that in the control group [18.2 (5.1-43.1)] (P < 0.001), whereas the PPCs were not significantly different among those with gram-positive bacteraemia, gram-negative bacteraemia, and fungal infection. Using receiver operating characteristic curves, the area under the curve of the platelet drop rate was 0.839 (95%CI: 0.783-0.895).

Conclusion: The percentage decline in platelet counts is sensitive in predicting bloodstream infection in patients with sepsis and septic shock. However, it cannot identify gram-positive bacteraemia, gram-negative bacteraemia, and fungal infection.

Keywords: Bloodstream infection; Platelet counts; Sepsis; Shock; Thrombocytopenia.