Predictors of ineffective platelet transfusion in surgical ICU: A retrospective study

Platelet transfusion is commonly utilized in the surgical intensive care unit (ICU) to provide hemostatic support for patients with severe thrombocytopenia or bleeding. Ineffective platelet transfusion is described as either the expected platelet count increase or insufficient hemostasis following transfusion. This study sought to identify risk factors and assess their predictive value in improving patient outcomes. This was an observational, retrospective study. Clinical information was gathered from 302 platelet transfusion episodes that occurred in the surgical ICU at the First Affiliated Hospital of Sun Yat-sen University, between June and December 2022. Based on the clinical bleeding improvement indices (drainage volume, hemoglobin level) and the 24 hour-corrected count increment, the patients were divided into effective and ineffective groups. Binomial logistic regression was used to identify independent risk factors for ineffective transfusion after univariate analysis was screened for significant variables ( P 1), liver disease, intraoperative bleeding (≤1600 vs >1600), procalcitonin (PCT) level, C-reactive protein level, splenomegaly, and age (≥65 vs .05). Univariate logistic regression revealed a significant association ( P 1) (odds ratio (OR) = 1.997, 95% confidence interval (CI): 1.196–3.335; P = .008), splenomegaly (OR = 3.912, 95% CI: 2.277–6.720; P 1), splenomegaly, and PCT level were independent risk factors for ineffective platelet transfusion, and the constructed model had moderate predictive efficacy, providing a reference for early clinical identification and intervention.