Early platelet count dynamics in septic ICU patients and their association with acute kidney injury and mortality

Abstract Background Acute kidney injury (AKI) refers to a condition in which the kidneys abruptly lose their ability to effectively filter waste products from the bloodstream. This work aimed to assess the dynamic changes in platelet count of intensive care unit (ICU) admission and determine their correlation with ICU mortality. Materials and methods This prospective cohort study involved 150 adult patients aged 18 years or older who were admitted to ICU with a confirmed diagnosis of sepsis and had available serial platelet measurements from Day 0 to Day 2. All patients underwent a comprehensive baseline assessment, baseline laboratory investigations. Results Platelet decline showed a strong and consistent association with AKI development. Lower platelet counts from Day 1 to Day 2 significantly increased the odds of AKI, with the most predictive parameter being Platelet Day 2 (OR = 0.984, 95% CI: 0.973–0.996, p = 0.006). Platelet percentage change also independently predicted AKI risk (OR = 0.965, 95% CI: 0.942–0.989, p = 0.007). All platelet count were significant predictors of ICU mortality. A greater decline in platelet count over time was related to higher odds ratio of death, with the strongest association observed for Platelet Day 2 (OR = 0.979, 95% CI: 0.966–0.992, p = 0.001) and platelet percentage change (OR = 0.960, 95% CI: 0.935–0.986, p = 0.003). Conclusion Our study provides compelling evidence that dynamic platelet monitoring over the first 72 h of ICU admission powerfully predicts both AKI development and mortality in septic patients.