Platelet indices in children with sepsis and their relation to the outcome

Subbiah M. Sriram, Shrikiran Aroor, Pushpa G. Kini, Shravan Kanaparthi, Kalyan Chakravarthy Konda

Research output: Contribution to journalArticle

Abstract

Introduction: Sepsis is a major causes of mortality and morbidity among children. An effective and accurate biochemical marker is needed which can support or exclude the diagnosis of sepsis. Objective: To study the platelet indices in children with sepsis and their relation to the outcome Method: A prospective observational study was conducted in a tertiary care centre from southern India from October 2015 to July 2017. Children aged 1 month to 18 years of age with sepsis, as per the definition of International Paediatric Sepsis Consensus Conference 2005, were included in the study. Children with no infection were taken as controls. Children with haematological malignancies, known platelet disorders, haemolytic anaemia and children with a history of recent blood transfusions or splenectomy were excluded from the study. History and physical examination findings were noted in a pre-designed proforma. Platelet indices were measured using an automated blood counter, Beckman Coulter LH780 series. Counts done at the time of admission and prior to discharge or death were taken for analysis. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) values were compared with standard normal values. Severity of thrombocytopenia was classified as mild (50,000- 150,000/cu mm), moderate (20,000-50,000/cu mm) and severe ( < 20,000 or < 50,000/cu mm with clinical bleeding) for the study purpose. Mean and median were used for data with normal and nonnormal distribution. Mann-Whitney was used for analysis of continuous variables. Chi-square was used for categorical variables. Analysis of mean was done using independent t-test. Data was analysed using SPSS version 21. Study protocol was approved by Institutional Ethics Committee (IEC No: 595/2015).Results: A total of 191 children with sepsis were enrolled in the study of which 40 were excluded. Thrombocytopenia was observed among 67.5% (102/151) of the study population with sepsis. The difference in platelet indices between cases and controls were found to be statistically significant. Mortality rate in the present study was 27.8% (42/151). Platelet count (p=0.003) and plateletcrit (p=0.004) were significantly low among nonsurvivors when compared to survivors with sepsis. Among the children who had thrombocytopenia prior to discharge, severity of thrombocytopenia showed significant relation with the outcome of children with sepsis (p=0.006). Conclusions: In the present study, plateletcrit, mean platelet volume, platelet distribution width and platelet count showed statistically significant relation in children with sepsis when compared to controls. With regard to predicting mortality, platelet count and plateletcrit showed statistically significant lower values among non survivors when compared to survivors.

Original languageEnglish
Pages (from-to)301-305
Number of pages5
JournalSri Lanka Journal of Child Health
Volume47
Issue number4
DOIs
Publication statusPublished - 01-01-2018

Fingerprint

Sepsis
Blood Platelets
Thrombocytopenia
Platelet Count
Mean Platelet Volume
Survivors
Mortality
Ethics Committees
Normal Distribution
Hemolytic Anemia
Splenectomy
Hematologic Neoplasms
Tertiary Care Centers
Blood Transfusion
Physical Examination
Observational Studies
India
Reference Values
Biomarkers
History

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Sriram, Subbiah M. ; Aroor, Shrikiran ; Kini, Pushpa G. ; Kanaparthi, Shravan ; Konda, Kalyan Chakravarthy. / Platelet indices in children with sepsis and their relation to the outcome. In: Sri Lanka Journal of Child Health. 2018 ; Vol. 47, No. 4. pp. 301-305.
@article{99764bf612d242ae94b60711f3017586,
title = "Platelet indices in children with sepsis and their relation to the outcome",
abstract = "Introduction: Sepsis is a major causes of mortality and morbidity among children. An effective and accurate biochemical marker is needed which can support or exclude the diagnosis of sepsis. Objective: To study the platelet indices in children with sepsis and their relation to the outcome Method: A prospective observational study was conducted in a tertiary care centre from southern India from October 2015 to July 2017. Children aged 1 month to 18 years of age with sepsis, as per the definition of International Paediatric Sepsis Consensus Conference 2005, were included in the study. Children with no infection were taken as controls. Children with haematological malignancies, known platelet disorders, haemolytic anaemia and children with a history of recent blood transfusions or splenectomy were excluded from the study. History and physical examination findings were noted in a pre-designed proforma. Platelet indices were measured using an automated blood counter, Beckman Coulter LH780 series. Counts done at the time of admission and prior to discharge or death were taken for analysis. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) values were compared with standard normal values. Severity of thrombocytopenia was classified as mild (50,000- 150,000/cu mm), moderate (20,000-50,000/cu mm) and severe ( < 20,000 or < 50,000/cu mm with clinical bleeding) for the study purpose. Mean and median were used for data with normal and nonnormal distribution. Mann-Whitney was used for analysis of continuous variables. Chi-square was used for categorical variables. Analysis of mean was done using independent t-test. Data was analysed using SPSS version 21. Study protocol was approved by Institutional Ethics Committee (IEC No: 595/2015).Results: A total of 191 children with sepsis were enrolled in the study of which 40 were excluded. Thrombocytopenia was observed among 67.5{\%} (102/151) of the study population with sepsis. The difference in platelet indices between cases and controls were found to be statistically significant. Mortality rate in the present study was 27.8{\%} (42/151). Platelet count (p=0.003) and plateletcrit (p=0.004) were significantly low among nonsurvivors when compared to survivors with sepsis. Among the children who had thrombocytopenia prior to discharge, severity of thrombocytopenia showed significant relation with the outcome of children with sepsis (p=0.006). Conclusions: In the present study, plateletcrit, mean platelet volume, platelet distribution width and platelet count showed statistically significant relation in children with sepsis when compared to controls. With regard to predicting mortality, platelet count and plateletcrit showed statistically significant lower values among non survivors when compared to survivors.",
author = "Sriram, {Subbiah M.} and Shrikiran Aroor and Kini, {Pushpa G.} and Shravan Kanaparthi and Konda, {Kalyan Chakravarthy}",
year = "2018",
month = "1",
day = "1",
doi = "10.4038/sljch.v47i4.8589",
language = "English",
volume = "47",
pages = "301--305",
journal = "Sri Lanka Journalof Child Health",
issn = "1391-5452",
publisher = "Sri Lanka College of Paediatricians",
number = "4",

}

Platelet indices in children with sepsis and their relation to the outcome. / Sriram, Subbiah M.; Aroor, Shrikiran; Kini, Pushpa G.; Kanaparthi, Shravan; Konda, Kalyan Chakravarthy.

In: Sri Lanka Journal of Child Health, Vol. 47, No. 4, 01.01.2018, p. 301-305.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Platelet indices in children with sepsis and their relation to the outcome

AU - Sriram, Subbiah M.

AU - Aroor, Shrikiran

AU - Kini, Pushpa G.

AU - Kanaparthi, Shravan

AU - Konda, Kalyan Chakravarthy

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Sepsis is a major causes of mortality and morbidity among children. An effective and accurate biochemical marker is needed which can support or exclude the diagnosis of sepsis. Objective: To study the platelet indices in children with sepsis and their relation to the outcome Method: A prospective observational study was conducted in a tertiary care centre from southern India from October 2015 to July 2017. Children aged 1 month to 18 years of age with sepsis, as per the definition of International Paediatric Sepsis Consensus Conference 2005, were included in the study. Children with no infection were taken as controls. Children with haematological malignancies, known platelet disorders, haemolytic anaemia and children with a history of recent blood transfusions or splenectomy were excluded from the study. History and physical examination findings were noted in a pre-designed proforma. Platelet indices were measured using an automated blood counter, Beckman Coulter LH780 series. Counts done at the time of admission and prior to discharge or death were taken for analysis. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) values were compared with standard normal values. Severity of thrombocytopenia was classified as mild (50,000- 150,000/cu mm), moderate (20,000-50,000/cu mm) and severe ( < 20,000 or < 50,000/cu mm with clinical bleeding) for the study purpose. Mean and median were used for data with normal and nonnormal distribution. Mann-Whitney was used for analysis of continuous variables. Chi-square was used for categorical variables. Analysis of mean was done using independent t-test. Data was analysed using SPSS version 21. Study protocol was approved by Institutional Ethics Committee (IEC No: 595/2015).Results: A total of 191 children with sepsis were enrolled in the study of which 40 were excluded. Thrombocytopenia was observed among 67.5% (102/151) of the study population with sepsis. The difference in platelet indices between cases and controls were found to be statistically significant. Mortality rate in the present study was 27.8% (42/151). Platelet count (p=0.003) and plateletcrit (p=0.004) were significantly low among nonsurvivors when compared to survivors with sepsis. Among the children who had thrombocytopenia prior to discharge, severity of thrombocytopenia showed significant relation with the outcome of children with sepsis (p=0.006). Conclusions: In the present study, plateletcrit, mean platelet volume, platelet distribution width and platelet count showed statistically significant relation in children with sepsis when compared to controls. With regard to predicting mortality, platelet count and plateletcrit showed statistically significant lower values among non survivors when compared to survivors.

AB - Introduction: Sepsis is a major causes of mortality and morbidity among children. An effective and accurate biochemical marker is needed which can support or exclude the diagnosis of sepsis. Objective: To study the platelet indices in children with sepsis and their relation to the outcome Method: A prospective observational study was conducted in a tertiary care centre from southern India from October 2015 to July 2017. Children aged 1 month to 18 years of age with sepsis, as per the definition of International Paediatric Sepsis Consensus Conference 2005, were included in the study. Children with no infection were taken as controls. Children with haematological malignancies, known platelet disorders, haemolytic anaemia and children with a history of recent blood transfusions or splenectomy were excluded from the study. History and physical examination findings were noted in a pre-designed proforma. Platelet indices were measured using an automated blood counter, Beckman Coulter LH780 series. Counts done at the time of admission and prior to discharge or death were taken for analysis. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) values were compared with standard normal values. Severity of thrombocytopenia was classified as mild (50,000- 150,000/cu mm), moderate (20,000-50,000/cu mm) and severe ( < 20,000 or < 50,000/cu mm with clinical bleeding) for the study purpose. Mean and median were used for data with normal and nonnormal distribution. Mann-Whitney was used for analysis of continuous variables. Chi-square was used for categorical variables. Analysis of mean was done using independent t-test. Data was analysed using SPSS version 21. Study protocol was approved by Institutional Ethics Committee (IEC No: 595/2015).Results: A total of 191 children with sepsis were enrolled in the study of which 40 were excluded. Thrombocytopenia was observed among 67.5% (102/151) of the study population with sepsis. The difference in platelet indices between cases and controls were found to be statistically significant. Mortality rate in the present study was 27.8% (42/151). Platelet count (p=0.003) and plateletcrit (p=0.004) were significantly low among nonsurvivors when compared to survivors with sepsis. Among the children who had thrombocytopenia prior to discharge, severity of thrombocytopenia showed significant relation with the outcome of children with sepsis (p=0.006). Conclusions: In the present study, plateletcrit, mean platelet volume, platelet distribution width and platelet count showed statistically significant relation in children with sepsis when compared to controls. With regard to predicting mortality, platelet count and plateletcrit showed statistically significant lower values among non survivors when compared to survivors.

UR - http://www.scopus.com/inward/record.url?scp=85060107951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060107951&partnerID=8YFLogxK

U2 - 10.4038/sljch.v47i4.8589

DO - 10.4038/sljch.v47i4.8589

M3 - Article

AN - SCOPUS:85060107951

VL - 47

SP - 301

EP - 305

JO - Sri Lanka Journalof Child Health

JF - Sri Lanka Journalof Child Health

SN - 1391-5452

IS - 4

ER -