In this international prospective cohort study of acutely admitted adult ICU patients, we found that 43% had thrombocytopenia; 23% at ICU admission and 20% developed it during ICU stay.

Patients with thrombocytopenia had worse outcomes, including 90-day mortality, and several conditions increased the risk of developing thrombocytopenia during ICU stay.

Twenty-three percent of patients with thrombocytopenia received platelet transfusion and most in-ICU transfusions were prophylactic.

The observed frequency of thrombocytopenia was similar to findings in smaller cohort studies in general mixed ICU populations, and in a larger cohort of ICU patients receiving thromboprophylaxis.

However, variation exists, which is likely due to differences in case mix, illness severity, follow-up time and definitions of thrombocytopenia.

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