A Study of Evaluation of Platelets as a Predictive Parameters in Severe Dengue Fever

S. Bochiwal, V. Vinod, Deepak Shukla
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Abstract

Introduction: Dengue fever is a common arthropod borne viral fever presenting with thrombocytopenia. There are number of study on thrombocytopenia and its correlation with severity of dengue fever, but results are conflicting. We want to study level of platelet count and its correlation with various complications of dengue like bleeding, DIC, hepatitis, shock etc. We would also like to evaluate platelet trends (increasing or decreasing) with various complication and outcome. Methods: It was prospective observational study over the period of one year. 90 Indoor patients with dengue with thrombocytopenia were studied after inclusion and exclusion criteria. Data entry and analysis was done in Microsoft excel through Descriptive statistic,’t’ test and chi-square tests. Results: In uncomplicated cases the mean platelet count was 54077± 42277 and in complicated cases the mean platelet count was 29500± 23197. This signifies platelet count were low in complicated dengue fever. This suggests that platelet count is surrogate marker of severity of dengue fever. With improving platelet count, most of patients survived, while patients with decreasing trend suggested poor outcome (p: less than 0.01) with 53 time higher chances of expiring as compared to patient with increasing trend of platelet(odd ratio:53.64). Severe thrombocytopenia was related with high mortality rate. Conclusion: From this study, we recommend that absolute platelet count and more specifically change in platelet count trend (increasing or decreasing) should be monitored closely as it can be used as a predictor of severity of dengue fever.
血小板作为重症登革热预测参数的评价研究
登革热是一种常见的节肢动物传播的病毒性发热,表现为血小板减少症。目前已有许多关于血小板减少症及其与登革热严重程度相关性的研究,但结果相互矛盾。我们希望研究血小板计数水平及其与登革热各种并发症如出血、DIC、肝炎、休克等的相关性。我们也想评估血小板的趋势(增加或减少)与各种并发症和结果。方法:前瞻性观察研究,为期1年。按纳入和排除标准对90例室内登革热伴血小板减少患者进行了研究。在Microsoft excel中通过描述性统计、t检验和卡方检验进行数据录入和分析。结果:无并发症患者平均血小板计数为54077±42277,并发症患者平均血小板计数为29500±23197。这表明合并登革热患者血小板计数较低。提示血小板计数是登革热严重程度的替代指标。随着血小板数量的增加,大多数患者存活,而血小板数量减少的患者预后较差(p < 0.01),其死亡几率比血小板数量增加的患者高53倍(奇比:53.64)。严重血小板减少症与高死亡率相关。结论:从本研究中,我们建议密切监测绝对血小板计数,更具体地说,血小板计数变化趋势(增加或减少),因为它可以作为登革热严重程度的预测指标。
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