DOI: https://doi.org/10.36347/sjams.2026.v14i08.005

Pages: 1112-1117

Purpose: Thrombocytopenia is common in intensive care unit (ICU) patients and is associated with adverse outcomes. We aimed to describe the frequency, severity and clinical impact of thrombocytopenia in a critically ill patients, with a focus on transfusion practices. Methods: We conducted a single-center prospective study of 98 adult patients admitted to ICU in a tertiary care hospital. Thrombocytopenia was defined as a platelet count <150×10⁹/L and classified by severity. Data on demographics, illness severity (APACHE II), platelet counts, bleeding events, transfusion requirements and clinical outcomes were collected. Logistic regression analysis was used to assess predictors of mortality. Results: Among 98 ICU patients, 38 (38.8%) had thrombocytopenia. Severity distribution was: mild 42.1%, moderate 23.7%, severe 18.4% and very severe 15.8%. Patients with thrombocytopenia had higher APACHE II scores (p<0.001) and higher 90 day mortality (68.4% vs. 21.7%, p= 0.013). Platelet transfusions were administered to 16 (42.1%) thrombocytopenic patients, with most transfusions given at platelet counts <50×10⁹/L. In multivariate analysis, thrombocytopenia (OR 8.45, 95% CI 2.80–25.52) and APACHE II score (OR 1.11, 95% CI 1.04–1.19) were independent predictors of mortality. Conclusion: Thrombocytopenia occurs in more than one third of critically ill ICU patients and is independently associated with increased mortality. Platelet transfusions are commonly used in severe thrombocytopenia, highlighting the need for evidence based transfusion strategies.