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The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus
Saravanakumari Vijayakumar1, Stalin Viswanathan2, Dheeraj Jain3
1Department of Pathology, Sri Lakshmi Narayana Institute of Medical Sciences and Hospital, Kudapakkam Post, Pondicherry 605502, India.
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.
Insights
Thrombocytopenia, a low platelet count, can help predict multiorgan dysfunction syndrome (MODS) in scrub typhus patients. This finding utilizes easily accessible platelet indices alongside other clinical factors for early risk assessment.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Platelet indices are established biomarkers for various infections, including tuberculosis, malaria, dengue, and septic shock.
- The predictive value of platelet indices for multiorgan dysfunction syndrome (MODS) in scrub typhus remains unexplored.
- Scrub typhus is a significant cause of febrile illness, and early identification of complications like MODS is crucial for patient outcomes.
Purpose of the Study:
- To investigate the utility of platelet indices in predicting MODS in patients diagnosed with scrub typhus.
- To identify significant clinical and laboratory predictors, including platelet indices, for MODS development in scrub typhus.
Main Methods:
- A three-year retrospective review of patient charts was conducted.
- Patients with and without MODS were compared using logistic regression analysis.
- Platelet indices (platelet count, mean platelet volume (MPV), plateletcrit) and other clinical/laboratory variables were analyzed.
Main Results:
- Significant differences were observed in respiratory rate, serum creatinine, liver function tests, platelet count, MPV, and plateletcrit between patients with and without MODS.
- Thrombocytopenia (platelet count <150 × 10^9/L), elevated creatinine, elevated alanine transaminase, and abnormal chest radiograph were significant predictors of MODS.
- ROC curve analysis was performed to assess the predictive capability of platelet indices for MODS.
Conclusions:
- Platelet indices, particularly thrombocytopenia, are valuable, inexpensive, and readily available indicators for predicting MODS in scrub typhus.
- Combining thrombocytopenia with creatinine, alanine transaminase, and chest radiograph findings enhances the prediction of MODS in scrub typhus patients.
- This study highlights the potential of incorporating platelet indices into routine clinical assessments for early MODS detection in scrub typhus.
