Lack of benefit of prophylactic platelet transfusion in adult dengue patients
Abstract number: P1634
Lye D.C., Lee V., Sun Y., Leo Y.S.
Objectives: Thrombocytopenia is common in dengue and there is concern about risk of bleeding. One retrospective paediatric intensive care study showed no benefit in prophylactic platelet transfusion for thrombocytopenia <30,000/uL. This study aims to determine if prophylactic platelet transfusion has clinical benefit in adult dengue patients.
Methods: All dengue patients admitted to our department in 2004 were retrospectively reviewed. Using data from the entire clinical course, all cases were re-classified into dengue fever and DHF based on World Health Organisation criteria. Patients without bleeding when their platelet count dropped <20,000/uL were evaluated. Prophylactic platelet transfusion was defined as platelet transfusion without clinical bleeding excluding petechiae. Baseline demographic data on admission and clinical data when patients' platelet count first dropped <20,000/uL were compared. Outcome measures included: any bleeding after platelet transfusion, median platelet increase the next day, median time to platelet count 50,000/uL, median length of hospital stay, and death.
Results: Of 1973 laboratory-confirmed dengue patients, 256 developed thrombocytopenia <20,000/uL without bleeding, of whom 188 were given prophylactic platelet transfusion. Baseline demographic, clinical and laboratory features at that platelet threshold were similar, except transfused patients were significantly more likely to be febrile (33% vs. 18%). Median platelet count on day of platelet transfusion was 15,000/uL in transfused vs. 16,000/uL in non-transfused patients. Bleeding occurred subsequently in 1 of 188 transfused (0.5%) and 2 of 68 non-transfused (3%) (p = 0.17). Median platelet increase the next day was 6000/uL vs. 13,000/uL, and median time to platelet 50,000/uL was 3 days vs. 2 days, in transfused vs. non-transfused patients respectively. There was no difference in length of stay and death.
Conclusions: There was no benefit from prophylactic platelet transfusion in adult dengue patients.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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