Thrombocytopenia in Sepsis and Septic Shock Patients: A Prospective Observational Study of Incidence and Correlation with Clinical Outcome

Background: Among intensive care unit (ICU) patients, thrombocytopenia is a common abnormality, having a prevalence of about 50%. This thrombocytopenia may lead to an increased risk of bleeding, impaired wound healing and organ haemorrhage in severe cases. Relative thrombocytopenia serves as a sign of heightened risk. Hence, addressing the thrombocytopenia early and regular monitoring helps in better management of sepsis patients. Methods: This prospective study analysed 115 patients diagnosed with sepsis and septic shock from April 2023 to December 2024 in a tertiary care hospital. Data collected includes demographic factors and clinical parameters (CBC, SOFA score, ICU stay duration, outcome and 28-day mortality). Results: Among 115 patients, 36.52% had thrombocytopenia. The 28-day mortality of sepsis patients with thrombocytopenia was 23.18% ( P < .001). Major bleeding episodes occurred in 40% patients with thrombocytopenia ( P = .034) and they also required transfusions of packed whole blood (73% P < .001), fresh frozen plasma (FFP) (67% P < .001), cryoprecipitate (26% P = .005) and platelets (45% P < .001). The 28-day mortality was lower among thrombocytopenic patients whose thrombocytopenia resolved compared with those in whom it did not resolve (40% vs. 60%, P < .0001). Conclusion: Sepsis patients developing thrombocytopenia face significantly worser outcome, especially in those whose platelet count did not resolve during the course, faces more risk of mortality. They also had the increased risk of major bleeding episodes and the need for multiple transfusions. These findings emphasize the need for routine monitoring of platelet counts in the sepsis patients.