Effect of presence of severe thrombocytopenia on prognosis of hepatic patients in intensive care unit

Abstract

Thrombocytopenia is defined as a platelet count below 150,000/μL. It is the most common hematological complication in patients with chronic liver disease (CLD).The prevalence of thrombocytopenia in chronic liver diseases ranges from 6 % among non-cirrhotic patients with chronic liver disease to 70 % among patients with liver cirrhosis (Khalil et al., 2019). The pathophysiology is multifactorial. Portal hyper-tension leads to splenomegaly and then splenic sequestration of platelets. In addition, thrombopoietin levels in patients with chronic liver disease are low, leading to decreased production of platelets. The combination of increased sequestration and decreased production leads to low platelet counts, which tend to correlate with both the degree of portal hypertension as well as with the degree of liver dysfunction. In other words, the more liver dysfunction, the lower the thrombopoietin levels, and also the more portal hypertension patients tend to have, which leads to progressive thrombocytopenia (Brown, 2019).