Raziye Sinem MISIRLIOĞLU, Emre ŞANCI, Kemal Can TERTEMİZ, Ersin AKSAY

Can thrombocytosis or thrombocytopenia predict complicated clinical course and 30-days mortality in patients with pneumonia?

Background/aim: While several different scoring systems aim to determine the clinical outcomes for patients with pneumonia, there is limited emphasis on the platelet count. This study investigated the relationships between thrombocyte count and 30-day mortality and complicated clinical course of patients with pneumonia. Materials and methods: This prospective cross-sectional study enrolled patients over 18 years old with a diagnosis of pneumonia in the emergency department for six months. The primary outcome was to establish the relationship between platelet count, mortality, complicated clinical course, and initial vital parameters on admission. The secondary outcome was comparing the platelet count with mortality and complicated clinical course during the hospital stay. Results: Four hundred-five patients were included (58.8% male, mean age 75.1 ± 12.7 years). On admission, thrombocytosis was observed in 14.1% and thrombocytopenia in 4.2%. There was no difference between the 30-day mortality according to the platelet count at admission and follow-up. Patients who developed thrombocytopenia during follow-up needed more intensive care admissions, invasive mechanical ventilation, noninvasive mechanical ventilation, and vasopressor treatment, while patients with thrombocytosis needed invasive mechanical ventilation more frequently. Conclusion: Neither thrombocytopenia nor thrombocytosis is not associated with 30-day mortality in ED patients with pneumonia. Thrombocytopenia during follow-up was associated with a higher incidence for a complicated clinical course.Key words: Pneumonia, platelet, thrombocytosis, thrombocytopenia, mortality, emergency medicine

PDF

___

1. De Stoppelaar SF, Claushuis TA, Schaap MC, Hou B, Van der Poll T et al. Toll-like receptor signalling is not involved in platelet response to streptococcus pneumoniae in vitro or in vivo. PLoS One 2016; 11 (6): e0156977. doi: 10.1371/journal.pone.0156977
2. Gunes Ozaydin M, Guneysel O, Saridogan F, Ozaydin V. Are scoring systems sufficient for predicting mortality due to sepsis in the emergency department? Turkish Journal of Emergency Medicine 2016; 17 (1): 25-28. doi: 10.1016/j.tjem.2016.09.004
3. Brogly N, Devos P, Boussekey N, Georges H, Chiche A et al. Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia. Journal of Infection 2007; 55 (2): 136-140. doi: 10.1016/j.jinf.2007.01.011
4. Mirsaeidi M, Peyrani P, Aliberti S, Filardo G, Bordon J et al. Thrombocytopenia and thrombocytosis at time of hospitalization predict mortality in patients with communityacquired pneumonia. Chest 2010; 137 (2): 416-420. doi: 10.1378/chest.09-0998
5. Prina E, Ferrer M, Ranzani OT, Polverino E, Cillóniz C et al. Thrombocytosis is a marker of poor outcome in communityacquired pneumonia. Chest 2013; 143 (3): 767-775. doi: 10.1378/chest.12-1235
6. Camon S, Quiros C, Saubi N, Moreno A, Marcos MA et al. Full blood count values as a predictor of poor outcome of pneumonia among HIV-infected patients. BMC Infectious Diseases 2018; 18 (1): 189. doi: 10.1186/s12879-018-3090-0
7. Gorelik O, Izhakian S, Barchel D, Almoznino-Sarafian D, Tzur I et al. Prognostic significance of platelet count changes during hospitalization for community-acquired pneumonia. Platelets 2017; 28 (4): 380-386 doi: 10.1080/09537104.2016.1219032