Author/Authors :
Choi Seung Jun نويسنده Division of Pediatric Critical Care Medicine, Department
of Pediatrics, Asan Medical Center Children’s Hospital, University
of Ulsan College of Medicine, Seoul, Republic of
Korea , Ha Eun-Ju نويسنده Division of Pediatric Critical Care Medicine, Department
of Pediatrics, Asan Medical Center Children’s Hospital, University
of Ulsan College of Medicine, Seoul, Republic of
Korea , Jhang Won Kyoung نويسنده Division of Pediatric Critical Care Medicine, Department
of Pediatrics, Asan Medical Center Children’s Hospital, University
of Ulsan College of Medicine, Seoul, Republic of
Korea , Jong Park Seong نويسنده Division of Pediatric Critical Care Medicine, Department
of Pediatrics, Asan Medical Center Children’s Hospital, University
of Ulsan College of Medicine, Seoul, Republic of
Korea
Abstract :
Background Platelet indices are used as predictive marker of
mortality in adult critically ill patients. Objectives To compare
platelet counts, mean platelet volumes (MPV), and platelet distribution
widths (PDW) in surviving and non-surviving pediatric septic shock
patients and to assess whether platelet count and indices can be
utilized as predictive markers of mortality in these patients. Methods A
retrospective study was performed based on collected data on pediatric
patients admitted for septic shock to pediatric intensive care unit.
Complete blood cell count, platelet counts, MPV, and PDW on admission
were compared in survivors and non-survivors, as well as in patients
with and without underlying hemato-oncologic disease. Results Of 83
children, 21 (25.3%) died within 28 days of hospital admission. Mean
platelet count was significantly higher in the 62 survivors than in 21
non-survivors (146.6 ± 133.7 ×
103/mm3 vs 46.1 ± 44.1 ×
103/mm3, P = 0.000). MPV
and PDW were also higher in survivors, though not statistically
significant (P = 0.059, P = 0.077). The platelet counts were
significantly higher in survivors than in non-survivors with (P = 0.044)
and without (P = 0.015) hemato-oncologic disease. Based on area under
receiver operating characteristic curves, platelet count was the
strongest predictor of mortality in pediatric patients without
underlying hemato-oncologic disease (area under the curve = 0.857). The
survival probability in this group was 96.77% when platelet count
exceeded 106.5 × 103/mm3.
Conclusions Thrombocytopenia is a useful predictive marker of mortality
in pediatric septic shock patients, both with and without underlying
hemato-oncologic disease.
