Please use this identifier to cite or link to this item: https://doi.org/10.1093/cid/ciz850
Title: Predictors and Clinical Outcomes of Poor Platelet Recovery in Adult Dengue With Thrombocytopenia: A Multicenter, Prospective Study
Authors: Archuleta, Sophia 
Chia, Po Ying
Wei, Yuan 
Syed-Omar, Sharifah F
Low, Jenny G 
Oh, Helen M
Fisher, Dale 
Ponnampalavanar, Sasheela SL
Wijaya, Limin 
Kamarulzaman, Adeeba
Lum, Lucy CS
Tambyah, Paul A 
Leo, Yee-Sin 
Lye, David C 
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
dengue
platelet transfusion
platelet recovery
HEMORRHAGIC-FEVER
VIRUS
TRANSFUSION
THROMBOPOIETIN
PATHOGENESIS
COAGULATION
Issue Date: 15-Jul-2020
Publisher: OXFORD UNIV PRESS INC
Citation: Archuleta, Sophia, Chia, Po Ying, Wei, Yuan, Syed-Omar, Sharifah F, Low, Jenny G, Oh, Helen M, Fisher, Dale, Ponnampalavanar, Sasheela SL, Wijaya, Limin, Kamarulzaman, Adeeba, Lum, Lucy CS, Tambyah, Paul A, Leo, Yee-Sin, Lye, David C (2020-07-15). Predictors and Clinical Outcomes of Poor Platelet Recovery in Adult Dengue With Thrombocytopenia: A Multicenter, Prospective Study. CLINICAL INFECTIOUS DISEASES 71 (2) : 383-389. ScholarBank@NUS Repository. https://doi.org/10.1093/cid/ciz850
Abstract: Background. Platelet transfusion is common in dengue patients with thrombocytopenia. We previously showed in a randomized clinical trial that prophylactic platelet transfusion did not reduce clinical bleeding. In this study, we aimed to characterize the predictors and clinical outcomes of poor platelet recovery in transfused and nontransfused participants. Methods. We analyzed patients from the Adult Dengue Platelet Study with laboratory-confirmed dengue with ≤20 000 platelets/ μL and without persistent mild bleeding or any severe bleeding in a post hoc analysis. Poor platelet recovery was defined as a platelet count of ≤20 000/μL on Day 2. We recruited 372 participants from 5 acute care hospitals located in Singapore and Malaysia between 29 April 2010 and 9 December 2014. Of these, 188 were randomly assigned to the transfusion group and 184 to the control group. Results. Of 360 patients, 158 had poor platelet recovery. Age, white cell count, and day of illness at study enrollment were significant predictors of poor platelet recovery after adjustment for baseline characteristics and platelet transfusion. Patients with poor platelet recovery had longer hospitalizations but no significant difference in other clinical outcomes, regardless of transfusion. We found a significant interaction between platelet recovery and transfusion; patients with poor platelet recovery were more likely to bleed if given a prophylactic platelet transfusion (odds ratio 2.34, 95% confidence interval 1.18-4.63). Conclusions. Dengue patients with thrombocytopenia who were older or presented earlier and with lower white cell counts were more likely to have poor platelet recovery. In patients with poor platelet recovery, platelet transfusion does not improve outcomes and may actually increase the risk of bleeding. The mechanisms of poor platelet recovery need to be determined.
Source Title: CLINICAL INFECTIOUS DISEASES
URI: https://scholarbank.nus.edu.sg/handle/10635/234524
ISSN: 1058-4838
1537-6591
DOI: 10.1093/cid/ciz850
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