Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients.
BACKGROUND:Thrombocytopenia is a hallmark of dengue infection, and bleeding is a dreaded complication of dengue fever. Prophylactic platelet transfusion has been used to prevent bleeding in the management of dengue fever, although the evidence for its benefit is lacking. In adult dengue patients wit...
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ftdoajarticles:oai:doaj.org/article:cc04fedeee284607bfe1b7f45a814ac7 2023-05-15T15:15:01+02:00 Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. Tau-Hong Lee Joshua G X Wong Yee-Sin Leo Tun-Linn Thein Ee-Ling Ng Linda K Lee David C Lye 2016-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004576 https://doaj.org/article/cc04fedeee284607bfe1b7f45a814ac7 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4807876?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004576 https://doaj.org/article/cc04fedeee284607bfe1b7f45a814ac7 PLoS Neglected Tropical Diseases, Vol 10, Iss 3, p e0004576 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004576 2022-12-31T11:40:43Z BACKGROUND:Thrombocytopenia is a hallmark of dengue infection, and bleeding is a dreaded complication of dengue fever. Prophylactic platelet transfusion has been used to prevent bleeding in the management of dengue fever, although the evidence for its benefit is lacking. In adult dengue patients with platelet count <20,000/mm3 without bleeding, we aimed to assess if prophylactic platelet transfusion was effective in reducing clinical bleeding and other outcomes. METHOD:We conducted a retrospective non-randomised observational study of dengue patients with platelet count < 20,000/mm3 without bleeding (except petechiae) admitted to Tan Tock Seng Hospital from January 2005 to December 2008. Baseline characteristics and clinical outcomes were compared between the non-transfused vs. transfused groups. Outcomes studied were clinical bleeding, platelet increment, hospital length of stay, intensive care unit admission and death. RESULTS:Of the 788 patients included, 486 received prophylactic platelet transfusion. There was no significant difference in the presence of clinical bleeding in the two groups (18.2% in non-transfused group vs. 23.5% in transfused group; P = 0.08). Patients in the transfused group took a median of 1 day longer than the non-transfused group to increase their platelet count to 50,000/mm3 or more (3 days vs. 2 days, P <0.0001). The median duration of hospital stay in the non-transfused group was 5 days vs. 6 days in the transfused group (P< 0.0001). There was no significant difference in the proportion requiring ICU admission (non-transfused 0.66% vs. transfused 1.23%, P = 0.44) and death (non-transfused 0% vs. transfused 0.2%, P = 0.43). CONCLUSION:Platelet transfusion in absence of bleeding in adult dengue with platelet count <20,000/mm3 did not reduce bleeding or expedite platelet recovery. There was potential harm by slowing recovery of platelet count to >50,000/mm3 and increasing length of hospitalization. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 3 e0004576 |
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Directory of Open Access Journals: DOAJ Articles |
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language |
English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Tau-Hong Lee Joshua G X Wong Yee-Sin Leo Tun-Linn Thein Ee-Ling Ng Linda K Lee David C Lye Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Thrombocytopenia is a hallmark of dengue infection, and bleeding is a dreaded complication of dengue fever. Prophylactic platelet transfusion has been used to prevent bleeding in the management of dengue fever, although the evidence for its benefit is lacking. In adult dengue patients with platelet count <20,000/mm3 without bleeding, we aimed to assess if prophylactic platelet transfusion was effective in reducing clinical bleeding and other outcomes. METHOD:We conducted a retrospective non-randomised observational study of dengue patients with platelet count < 20,000/mm3 without bleeding (except petechiae) admitted to Tan Tock Seng Hospital from January 2005 to December 2008. Baseline characteristics and clinical outcomes were compared between the non-transfused vs. transfused groups. Outcomes studied were clinical bleeding, platelet increment, hospital length of stay, intensive care unit admission and death. RESULTS:Of the 788 patients included, 486 received prophylactic platelet transfusion. There was no significant difference in the presence of clinical bleeding in the two groups (18.2% in non-transfused group vs. 23.5% in transfused group; P = 0.08). Patients in the transfused group took a median of 1 day longer than the non-transfused group to increase their platelet count to 50,000/mm3 or more (3 days vs. 2 days, P <0.0001). The median duration of hospital stay in the non-transfused group was 5 days vs. 6 days in the transfused group (P< 0.0001). There was no significant difference in the proportion requiring ICU admission (non-transfused 0.66% vs. transfused 1.23%, P = 0.44) and death (non-transfused 0% vs. transfused 0.2%, P = 0.43). CONCLUSION:Platelet transfusion in absence of bleeding in adult dengue with platelet count <20,000/mm3 did not reduce bleeding or expedite platelet recovery. There was potential harm by slowing recovery of platelet count to >50,000/mm3 and increasing length of hospitalization. |
format |
Article in Journal/Newspaper |
author |
Tau-Hong Lee Joshua G X Wong Yee-Sin Leo Tun-Linn Thein Ee-Ling Ng Linda K Lee David C Lye |
author_facet |
Tau-Hong Lee Joshua G X Wong Yee-Sin Leo Tun-Linn Thein Ee-Ling Ng Linda K Lee David C Lye |
author_sort |
Tau-Hong Lee |
title |
Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
title_short |
Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
title_full |
Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
title_fullStr |
Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
title_full_unstemmed |
Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients. |
title_sort |
potential harm of prophylactic platelet transfusion in adult dengue patients. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004576 https://doaj.org/article/cc04fedeee284607bfe1b7f45a814ac7 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 3, p e0004576 (2016) |
op_relation |
http://europepmc.org/articles/PMC4807876?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004576 https://doaj.org/article/cc04fedeee284607bfe1b7f45a814ac7 |
op_doi |
https://doi.org/10.1371/journal.pntd.0004576 |
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PLOS Neglected Tropical Diseases |
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10 |
container_issue |
3 |
container_start_page |
e0004576 |
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1766345415763951616 |