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Abstract
There were several studies performed on the issues of mortality in the elderly, the results of these studies reported that the mortality rate was quite high among elderly receiving long term care and the common causes of death among elderly people are malignancy, heart failure, pulmonary tuberculosis, intracerebral and other intracranial hemorrhage, pneumonia and intestinal infection.
They also tried to find relationship between mortality and some ICU parameters and they found that high APACHE III score, nosocomial infections, pressure ulcers, and use of inotropic drugs were associated with higher mortality rate, also ICU admission and delirium used as predictors for mortality and morbidity.
With age, average values of hemoglobin and hematocrit decrease slightly but remain within the adult range.
Platelet counts have been reported as either normal or slightly decreased and platelet function has been reported as normal, decreased or increased.
Thrombocytopenia is a common problem in the ICU and has been considered to play a role in worsening the prognosis of ICU patients.
There were several researches discussed the issues of the outcome of thrombocytopenia among critically ill patients as thrombocytopenia occurs frequently in critically ill patients and probably reflects the severity and progression of an underline disease.
The current study was a prospective study conducted to assess the relationship between thrombocytopenia and mortality among critically ill elderly as 110 patients was subjected to a comprehensive geriatric assessment.
CBC on admission was done then repeated platelet count with average 3-5 days.
Patients were followed during the period of admission in the ICU as regards medication, mechanical ventilation, central line insertion, new medical problems and the medications used till discharge from the ICU or death, then the relation between thrombocytopenia either on admission or developed in the ICU was correlated to the mortality in the ICU.
It was found through the results of the study that the mortality rate was high among patients who had either thrombocytopenia on admission or developed thrombo-cytopenia during their admission and correction of thrombocytopenia was associated with decreased risk of mortality, also thrombocytopenic patients had longer ICU stay and require mechanical ventilation and central line insertion than non thrombocytopenic patients.
There was no significant statistical relation between the cause of admission as (respiratory failure, myocardial infarction, rapid AF, heart failure, pulmonary edema, diabetic coma, renal failure, hypovolemic shock, hepatic encephalopathy and recent cerebrovascular stroke) and the development of thrombocytopenia. There was no significant relation between common medical diseases as anemia, bronchial asthma, cancer, COPD, depression, heart diseases, hypertension, liver cirrhosis, kidney diseases and the development of thrombocytopenia
Ampicillin followed by ranitidine are the most frequently used drugs among patients who developed thrombocytopenia during their admission in the ICU.