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Characterization of Thrombocytopenia in Pediatric Patients in Noncritical Hospital Setting: An Institutional Review
Haleema Urooj1, Sadaf Altaf2, Eisha Saadat3
1Section of Hematology and Transfusion Medicine, Department of Pathology and Laboratory Medicine.
Insights
Pediatric thrombocytopenia occurred in 8.3% of children post-flood, primarily due to infections. Most cases were mild, with minimal bleeding or need for platelet transfusions.
Area of Science:
- Pediatric Hematology
- Critical Care Medicine
- Epidemiology
Background:
- Pediatric thrombocytopenia (low platelet count) is common in critical care and oncology.
- Seasonal influences on childhood thrombocytopenia are poorly understood.
- Post-flood periods may present unique health challenges.
Purpose of the Study:
- To determine the frequency and severity of pediatric thrombocytopenia after a flood.
- To identify the primary causes and clinical outcomes of thrombocytopenia in children during this period.
Main Methods:
- Retrospective study of pediatric patients (1-18 years) with thrombocytopenia (platelet count <150×10^9/L).
- Data collected from electronic health records and laboratory systems (August-December 2022).
- Analysis of thrombocytopenia severity, causes, leucopenia, bleeding, and transfusions.
Main Results:
- 192 of 2318 admitted patients (8.3%) had thrombocytopenia.
- Infection was the main cause (91.1%), with mild thrombocytopenia in 56.8%.
- Bleeding (7.8%) and transfusions (92% discharged stable) were minimal.
Conclusions:
- Pediatric thrombocytopenia in non-critical/oncology settings post-flood is <10% and linked to infections.
- Low platelet counts in this cohort had a favorable prognosis with minimal complications.
Abstract:
Pediatric thrombocytopenia is frequently observed in critical care and oncology settings with an increased risk of bleeding and platelet transfusions. However, little is known about low platelets in childhood during seasonal influence. This study aimed to evaluate the frequency and severity of pediatric thrombocytopenia in the postflood period. The patients 1 to 18 years of age with thrombocytopenia (platelet count <150×109/L) were studied from August to December 2022 after institutional ethical approval (ERC-Path-2022-8044-23395). Data was collected from electronic health records and laboratory information systems. Of 2318 admitted patients, 192 (8.3%) including 128 males and 64 females had thrombocytopenia. The median (IQR) age was 12 (8 to 15) years. Mild, moderate, and severe thrombocytopenia were seen in 109 (56.8%), 76 (39.5%), and 7 (3.6%) patients, respectively. Concomitant leucopenia was observed in 77 of 192 patients (40.1%). Infection was the predominant cause of low platelets (N=175 or 91.1%). Only 15 patients (7.8%) had grade 1/2 bleeding. Overall, 176 patients (92%) were discharged in stable conditions and no mortality was observed. The frequency of pediatric thrombocytopenia in the noncritical and nononcological care settings was <10% and mostly observed in association with underlying infections. The frequency of bleeding manifestation and platelet transfusions was minimal in this group.
