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The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus.

ABSTRACT: Platelet indices have been used to diagnose and prognosticate infections such as tuberculosis, malaria, dengue, and septic shock. Platelet indices have previously not been used in the prediction of multiorgan dysfunction (MODS) in patients with scrub typhus. A three-year retrospective review of patient charts was performed. Patients with and without MODS were compared. Platelet indices and other clinical and laboratory variables were used in logistic regression analysis to determine significant predictors. A ROC curve was generated with the platelet indices to predict MODS. Of 189 patients, 106 were male. Respiratory rate, serum creatinine, liver function tests, platelet count, thrombocytopenia <150?×?109/L, mean platelet volume (MPV)?>?7.3?fL, and plateletcrit??0.19% varied significantly between patients with MODS and those without. Platelet indices are inexpensive and easily available. Only thrombocytopenia along with creatinine, alanine transaminase, and abnormal chest radiograph could significantly predict MODS in patients with scrub typhus.

SUBMITTER: Vijayakumar S

PROVIDER: S-EPMC7415085 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus.

Vijayakumar Saravanakumari S Viswanathan Stalin S Jain Dheeraj D

Interdisciplinary perspectives on infectious diseases 20200731

Platelet indices have been used to diagnose and prognosticate infections such as <i>tuberculosis</i>, malaria, dengue, and septic shock. Platelet indices have previously not been used in the prediction of multiorgan dysfunction (MODS) in patients with scrub typhus. A three-year retrospective review of patient charts was performed. Patients with and without MODS were compared. Platelet indices and other clinical and laboratory variables were used in logistic regression analysis to determine signi ...[more]

PMID: 32802052

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Project description:Background:The commonly available platelet indices are platelet distribution width (PDW), plateletcrit (PCT), and mean platelet volume (MPV). They have been used in diagnosis and prognosis of various abdominal disorders. They have never been used to predict severity of alcoholic hepatitis. Methods:A retrospective analysis of chronic alcohol consumers presenting with jaundice and deranged liver function tests was performed. Maddrey discriminant function (MDF) and modified end-stage liver disease (MELD) scores were calculated and patients compared between severe and nonsevere alcoholic hepatitis (MDF ?32 vs MDF <32 and MELD >20 vs MELD ?20). Logistic regression analysis was performed to find significant predictors. Receiver operating characteristic was used to find the area under the curve. Spearman correlation was performed to discover association between platelet indices and severity scores. Results:There were 119 patients in the study. Coexisting illnesses included pancreatitis, cirrhosis, infections, and alcohol withdrawal syndrome. The mean age (years), duration of alcohol consumption (years), and ethanol (g/day) were 45.13?±?11.53, 18.84?±?11.40, and 65.61?±?45.42, respectively. The average MELD and Maddrey scores were 14.13?±?5.17 and 36.45?±?29.63, respectively. The mean platelet counts, PDW, MPV, and PCT were 194.01?±?178.82?×?109/L, 17.10?±?1.21, 5.99?±?0.96, and 0.14?±?0.04, respectively. PDW >18 and MPV had a significant positive correlation with MELD scores. Only bilirubin and prothrombin prolongation were significant predictors of severe alcoholic hepatitis. The area under the curve was highest for PCT at 0.622 (P?=?.07; confidence interval?=?0.500-0.743). Conclusions:Platelet indices appear to be significantly altered in alcoholic hepatitis, but they do not predict severe disease. Whether this inability to predict severe alcoholic hepatitis is due to coexisting illnesses such as pancreatitis, cirrhosis, and infection needs to be studied further.

Dataset Information

The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus.

Publications

The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus.

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