New-onset thrombocytopenia in critically ill sepsis patients: A cross-sectional observational study

The study aims to evaluate the prevalence, risk factors, causes, and outcomes of new-onset thrombocytopenia among ICU patients with sepsis. Thrombocytopenia, defined as a platelet count below 150,000/mm³, is a frequent hematological abnormality in critically ill patients, particularly in sepsis, with an incidence ranging from 13% to 60%. It can result from decreased platelet production, increased destruction, or sequestration, and in septic patients, is associated with poor prognosis including higher acute kidney injury rates, prolonged vasopressor use, extended ICU stays, major bleeding, and increased mortality. The study will be conducted from June 2025 to December 2026 in the ICU of Sharda Hospital as a hospital-based cross-sectional observational study. Based on prior research indicating a 47% incidence in septic patients, the calculated sample size is 95 patients. Adults over 18 years with sepsis, as defined by SOFA score criteria, will be included, while patients who refuse consent, those under 18, with hematological malignancies, or who are pregnant will be excluded. Data will be collected through daily evaluations, CBC with platelet count monitoring, sepsis severity scoring, assessment of organ dysfunctions, infection source identification, medication review, and outcome measures including ICU stay, ventilation duration, and mortality. Ethical clearance has been obtained, informed consent will be taken from legal representatives, and participation will be free of cost, with minimal risk from blood sampling. Previous literature, such as Venkata et al. (2013) and Sharma et al. (2007), has shown high thrombocytopenia incidence in septic patients and strong associations with worse outcomes, with unresolved thrombocytopenia significantly increasing mortality. This study seeks to further clarify these associations and identify key predictors in the local ICU population.