Clinical trial NCT06908408: Correlation Between Base Excess in Patients Upon Admission to the ICU and Platelet Count Trend in the Following Days
Official title: Correlation Between the Severity of Metabolic Acidosis in Patients on Admission to the ICU and Platelet Count Trend in the Following Days
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Platelet Count Decline in Critically Ill
Metabolic Acidosis
Metabolic Acidosis Severity
Platelet Count Decline in ICU Patients
Keywords: metabolic acidosis severity
BE
relative platelet count decline in critically ill
base excess
platelet count decline in critically ill
Lead sponsor: University Medical Centre Ljubljana
Sponsor class: OTHER
First posted: 2025-04-03
Enrollment: 484
Sex: ALL
Minimum age (years): 14
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Study has been conducted at the Department of Anaesthesiology and Surgical Intensive Care at University Medical Centre Ljubljana. All participants, admitted to the ICU of Department of Anaesthesiology and Surgical Intensive Care in 2020 were included.

Brief summary: Several studies have revealed that a relative platelet count decline in patients after their admission to the intensive care unit (ICU) is a very reliable marker of the severity of their sickness. ICU patients with a greater platelet count decline after their admission to the ICU have generally worse outcome. Investigators assume that a quick appearance of a deep metabolic acidosis, which commonly occurs in critically ill, has an important role in pathogenesis of relative platelet count decline. To evaluate this, correlation of metabolic acidosis severity in participants upon admission to the ICU with platelet count decline in 2 days, following admission, was investigated with a retrospective observational study, analysing all participants, admitted to the ICU in one year period (in 2020).

As a measurement of metabolic acidosis severity, investigators took base excess (BE) value (expressed in mmol/L) from arterial blood gas analysis with lowest pH in participants in around admission time (in a period from 24 hours before to 24 hours after their admission to the ICU). To calculate relative platelet count decline in 2 days after admission to the ICU, investigators took platelet count on admission to the ICU (P0) and lowest platelet count on day 2 after the patient's admission (P2). Following formula was used to calculate relative platelet count decline in 2 days after ICU admission (delta P): delta P = (P2-P0)/P0 x 100 (expressed in %). More negative values of delta P represent larger relative platelet count decline.

The main interest of the study was if BE value correlates with delta P. Investigators assumed that participants with a more severe metabolic acidosis upon admission to the ICU (represented with more negative BE value) would tend to have a larger relative platelet count decline in 2 days, following admission to the ICU (represented with more negative value of delta P).

Pearson correlation was used to evaluate correlation between BE and delta P.

Detailed description: The aim of the study was to answer the question, if metabolic acidosis severity in participants upon admission to the ICU correlatets with platelet count decline in days, following admission.

Investigators conducted this study at the Department of Anesthesiology and Surgical Intensive Care at University Medical Centre Ljubljana. The study included all participants, admitted to the ICU in a one-year period (in 2020; from 1st January to 31st December 2020). From the electronic recordings of the department (Hospital Information System BIRPIS21), investigators obtained the following data of each participant: age, gender, lowest pH in arterial blood gas analysis in around admission time with corresponding bicarbonate concentration \[HCO3-\] and BE value, platelet count on admission (P0), and lowest platelet count on second day after ICU admission (P2).

As a measurement of metabolic acidosis severity, investigators took the BE value of arterial blood gas analysis with the lowest pH from the range of 24 hours before to 24 hours after ICU admission. To calculate relative platelet count decline in 2 days after ICU admission (delta P), the following formula was used: delta P = (P2-P0)/P0 x 100.

Participants who died before the second day after ICU admission or participants whose demanded laboratory findings were for some other reasons lacking (arterial blood gas analysis or platelet count on admission or platelet count on second day after ICU admission), were excluded from final analysis of correlation between BE and delta P.

Pearson's correlation coefficient (r) with 95% confidence interval (CI) was used to estimate the association between BE and delta P.

Eligibility criteria: Inclusion Criteria:

* Admitted to the ICU department in a 1 year period (from 1st January to 31th December 2020)

Exclusion Criteria:

* Lacking blood gas analysis data on admission
* Incomplete platelet count data (lacking platelet count on admission to the ICU and day 2 after the admission)

Primary outcomes:
measure: Relative platelet count decline in participants from admission to the ICU to their second day after ICU admission
timeFrame: From admission to the ICU (base line) and 2 days following admission
Secondary outcomes:
Other outcomes:
Locations:
city: Ljubljana
country: Slovenia
facility: University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
Study officials:
affiliation: Department of Anaesthesiology and Surgical Intensive Care
name: Primož Gradišek, MD, PhD, Prof.
role: STUDY_CHAIR
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