Correlation study between platelet count, leukocyte count, nonhemorrhagic complications, and duration of hospital stay in dengue fever with thrombocytopenia

Abstract

Introduction:Dengue is one of the common diseases presenting as fever with thrombocytopenia, also causing significant morbidity and complications.Objectives:Though the correlation between platelet count, bleeding manifestations and hemorrhagic complications has been extensively studied, less is known about the correlation between platelet count and non hemorrhagic complications. This study was done to see the correlation between platelet count and non hemorrhagic complications, duration of hospital stay and additive effect of leucopenia with thrombocytopenia on complications.Methods:Our study is prospective observational study done on 99 patients who had dengue fever with thrombocytopenia. Correlations were obtained using scatter plot and SPSS software trail version.Results:Transaminitis (12.12%) was the most common complication followed by acute renal injury (2%). In our study we found that, as the platelet count decreased the complication rate increased (P = 0.0006). In our study duration of hospital increased (P is 0.00597) with decreasing platelet count when compared to other study where there was no correlation between the two. There was no correlation between thrombocytopenia with leucopenia and complications (P is 0.292), similar to other study.Conclusion:Platelet count can be used to predict the complication and duration of hospital stay and hence better use of resources.

The total leucocyte count: its utility in dengue

“…23,24 A few studies had a lower and others, a higher proportion of cases with leucopenia. 1,2,4,15,16,18,25 A normal leucocyte count was observed in 55% of cases in our study in concordance with few studies but it was lower and higher in other studies. 2,4,15,18,21,24 Leucocytosis was noted in 9% of cases in our study in concordance with few studies.…”

“…16,17 In their study Juan Carlos et al have observed that leucopenia is accompanied by a sudden drop in platelet count preceding plasma leakage. Our study suggests that leucopenia could be a marker of severe dengue as over half (52%) of the cases are associated with severe thrombocytopenia.…”

“…7,18 However other studies dispute the role of leucopenia as a prognosticator. 15,16,17 On the other hand, few studies claim that leucopenia indicates good prognosis with counts >5x10 9 /l being associated with severe dengue. 10,13,14 Vibha et al noted that leucopenia is commoner in Dengue fever, Dengue hemorrhagic fever I/II but not in Dengue shock syndrome.…”

“…12,19,20 Some studies have observed that total leucocyte counts/leucopenia could serve as a prognostic factor for dengue severity while others dispute it. 10,[13][14][15][16][17]21,22 A few studies have observed that there is a progressive decline in white cell counts with sudden platelet drop which precedes plasma leakage and hence it could be the earliest prognosticator of severe dengue. 23 Our study focuses on the significance and patterns of one such simple, routine test the total white cell count in diagnosis of dengue.…”

“…9,14 The earliest hematological abnormality in dengue is a progressive decline in white cell counts. [15][16][17] Leucopenia, defined as total leucocyte count <4x10 9 /l is a prominent and supposedly the second most common feature in dengue. 9,18 It gives enough clue for diagnosis of Dengue and helps in differentiation from other febrile illnesses thus aiding in reducing its morbidity and mortality.…”