The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis
Abstract Background Thrombocytopenia (TCP) is a common finding in critically ill patients that has been linked to a worse prognosis. Specifically, sepsis is a major risk factor for TCP. Several observational studies have examined the prognostic role of TCP and its correlation with clinical outcomes...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-025-03188-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849401820361785344 |
|---|---|
| author | Basel F. Alqeeq Mohammed Ayyad Maram Albandak Waseem J. Almadhoun Mahmoud Kullab Ahmed W. Ghabayen Mohammed Al-Tawil |
| author_facet | Basel F. Alqeeq Mohammed Ayyad Maram Albandak Waseem J. Almadhoun Mahmoud Kullab Ahmed W. Ghabayen Mohammed Al-Tawil |
| author_sort | Basel F. Alqeeq |
| collection | DOAJ |
| description | Abstract Background Thrombocytopenia (TCP) is a common finding in critically ill patients that has been linked to a worse prognosis. Specifically, sepsis is a major risk factor for TCP. Several observational studies have examined the prognostic role of TCP and its correlation with clinical outcomes in patients with sepsis. Methods We conducted a systematic search through Medline, Scopus and CENTRAL, from inception until June 2024, in order to identify studies that discussed the effects of TCP on clinical outcomes in patients with sepsis or septic shock. This review was performed in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Study endpoints were ICU mortality, 28-day mortality, major bleeding and mechanical ventilation. Results We included twelve studies enrolling 14,093 patients in this meta-analysis. TCP was diagnosed at intensive care unit (ICU) admission in 5481 (39%) patients; on the other hand, it was encountered during the course of ICU stay in 1474 (10%) cases. Patients with TCP had significantly higher risks of ICU mortality (Odds Ratio: 1.93, 95% CI [1.6–2.33]; p < 0.01). and 28-day mortality (odds ratio: 1.98, 95% CI [1.67, 2.35]; p < 0.00001). Furthermore, patients with severe TCP (platelet count < 50 * 109/L) had even higher odds of ICU mortality (odds ratio: 3.38, 95% CI [2.25, 5.08]; p < 0.00001). Major bleeding events were significantly more frequent in patients with TCP (odds ratio: 3.26, 95% CI [2.26, 4.72]; p < 0.01). Conclusion TCP exhibits significant clinical implications in critically ill patients admitted with sepsis and is associated with enhanced mortality and worse clinical outcomes. Nonetheless, this meta-analysis quantifies the significant association between TCP and poor clinical outcomes in patients with sepsis and septic shock. |
| format | Article |
| id | doaj-art-bb32bbe413b5431bb481d572d9c94531 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj-art-bb32bbe413b5431bb481d572d9c945312025-08-20T03:37:41ZengBMCBMC Anesthesiology1471-22532025-07-0125111210.1186/s12871-025-03188-7The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysisBasel F. Alqeeq0Mohammed Ayyad1Maram Albandak2Waseem J. Almadhoun3Mahmoud Kullab4Ahmed W. Ghabayen5Mohammed Al-Tawil6Faculty of Medicine, Islamic University of GazaDepartment of Internal Medicine, Rutgers New Jersey Medical SchoolDepartment of Internal Medicine, University of ToledoFaculty of Medicine, Islamic University of GazaFaculty of Medicine, Al-Quds UniversityFaculty of Medicine, Al-Quds UniversityFaculty of Medicine, Al-Quds UniversityAbstract Background Thrombocytopenia (TCP) is a common finding in critically ill patients that has been linked to a worse prognosis. Specifically, sepsis is a major risk factor for TCP. Several observational studies have examined the prognostic role of TCP and its correlation with clinical outcomes in patients with sepsis. Methods We conducted a systematic search through Medline, Scopus and CENTRAL, from inception until June 2024, in order to identify studies that discussed the effects of TCP on clinical outcomes in patients with sepsis or septic shock. This review was performed in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Study endpoints were ICU mortality, 28-day mortality, major bleeding and mechanical ventilation. Results We included twelve studies enrolling 14,093 patients in this meta-analysis. TCP was diagnosed at intensive care unit (ICU) admission in 5481 (39%) patients; on the other hand, it was encountered during the course of ICU stay in 1474 (10%) cases. Patients with TCP had significantly higher risks of ICU mortality (Odds Ratio: 1.93, 95% CI [1.6–2.33]; p < 0.01). and 28-day mortality (odds ratio: 1.98, 95% CI [1.67, 2.35]; p < 0.00001). Furthermore, patients with severe TCP (platelet count < 50 * 109/L) had even higher odds of ICU mortality (odds ratio: 3.38, 95% CI [2.25, 5.08]; p < 0.00001). Major bleeding events were significantly more frequent in patients with TCP (odds ratio: 3.26, 95% CI [2.26, 4.72]; p < 0.01). Conclusion TCP exhibits significant clinical implications in critically ill patients admitted with sepsis and is associated with enhanced mortality and worse clinical outcomes. Nonetheless, this meta-analysis quantifies the significant association between TCP and poor clinical outcomes in patients with sepsis and septic shock.https://doi.org/10.1186/s12871-025-03188-7TCPPlateletsIntensive care unitSepsisSeptic shock |
| spellingShingle | Basel F. Alqeeq Mohammed Ayyad Maram Albandak Waseem J. Almadhoun Mahmoud Kullab Ahmed W. Ghabayen Mohammed Al-Tawil The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis BMC Anesthesiology TCP Platelets Intensive care unit Sepsis Septic shock |
| title | The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis |
| title_full | The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis |
| title_fullStr | The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis |
| title_full_unstemmed | The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis |
| title_short | The clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis |
| title_sort | clinical significance of thrombocytopenia in sepsis and septic shock a systematic review and meta analysis |
| topic | TCP Platelets Intensive care unit Sepsis Septic shock |
| url | https://doi.org/10.1186/s12871-025-03188-7 |
| work_keys_str_mv | AT baselfalqeeq theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mohammedayyad theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT maramalbandak theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT waseemjalmadhoun theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mahmoudkullab theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT ahmedwghabayen theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mohammedaltawil theclinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT baselfalqeeq clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mohammedayyad clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT maramalbandak clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT waseemjalmadhoun clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mahmoudkullab clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT ahmedwghabayen clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis AT mohammedaltawil clinicalsignificanceofthrombocytopeniainsepsisandsepticshockasystematicreviewandmetaanalysis |