DOI: 10.36347/sjams.2019.v07i01.025

Pages: 136-141

Thrombocytopenia is encountered in day to day clinical practice and the criterion for patient’s admission in the intensive care unit (ICU) depends upon various risk factors. APACHE II and many other scoring systems are generally used in ICU patients to assess the mortality risk. Studies have revealed the use of hematological indices analyzed in counters in predicting the outcome of various diseases. Platelet indices such as Mean platelet Volume(MPV)Platelet Distribution Width(PDW) and Plateletcrit(PCT)as considered as the markers of platelet activation. Hence we attempted to compare the platelet indices with APACHE II scoring system in assessing the risk severity in patients admitted in ICU with thrombocytopenia. The study was conducted in a tertiary care hospital, south india. A cross sectional descriptive study was conducted over a period of year (2017-2018).Patients who were admitted in ICU with thrombocytopenia were evaluated with clinical details. Thrombocytopenia workup including complete blood counts, platelet indices and peripheral blood picture was carried out. APACHEII score, Estimated and Percentage mortality were calculated. Statistical analysis was done by using commercially available statistical software packages. We found a cause related mortality risk particularly in sepsis where there is severe thrombocytopenia and among the platelet indices PDW showed a significant correlation with APACHEII score, estimated and Percentage mortality(p=0.046,r=0.026,p=0.031)respectively. We also found significant correlation of platelet count and plateletcrit with percentage mortality (p=0.053,r=-0.197,p=0.023,r=-0.230).Percentage mortality had a causal relationship and in our study it had an inverse association with platelet count and plateletcrit in assessing the disease severity. In cases of thrombocytopenia, PDW can be utilized in estimating the disease severity in cases of sepsis along with APACHEII scoring system among critically ill patients.