Distribution and Aetiology of Thrombocytosis in Inpatients Setting of a Tertiary Care Hospital: A Cross-section Study from Western Maharashtra, India

Abstract

Introduction: Thrombocytosis is characterised by an increased platelet count in the blood, defined as a count greater than 450,000 cells/μL. The incidental discovery of thrombocytosis often leads to unnecessary investigations and referrals, causing anxiety among physicians. Aim: This study aims to examine the presence, frequency, and etiological distribution of thrombocytosis in various disease conditions. Materials and Methods: This cross-sectional observational study was conducted at the Central Clinical Laboratory of MIMER Medical College and Dr. BSTR tertiary care hospital in Talegaon Dabhade, Pune, Maharashtra, India, from June 1st, 2021, to August 31st, 2021. Clinical and laboratory data were collected from adult patients with a platelet count greater than 450,000 cells/μL and entered into a Microsoft Excel sheet. The parameters studied included age, sex, clinical diagnosis, platelet count, Total Leucocyte Count (TLC), absolute neutrophil count, Neutrophil Lymphocyte Ratio (NLR), haemoglobin levels, and C-reactive protein (CRP). Pearson’s correlation coefficient was calculated using Statistical Package for the Social Sciences (SPSS) software version 26.0. Results: A total of 194 patients with a platelet count greater than 450,000 cells/μL were included in the study. The frequency of thrombocytosis was 8.50% (194 patients), with 113 cases in the Medicine Inpatient Department (IPD) and 81 cases in the Surgery IPD. The lowest platelet count observed was 454,000 cells/μL, while the highest was 855,000 cells/μL. Primary thrombocytosis was found in 2 (1.03%) patients, while secondary thrombocytosis was found in 192 (98.96%) patients. A statistically significant association was observed between thrombocytosis and ferritin (p-value=0.032). Additionally, significant associations were found between thrombocytosis and absolute neutrophil count (p-value=0.023) and NLR (p-value=0.047). Conclusion: Elevated platelet counts, discovered during routine blood examinations, carry diagnostic, prognostic, and therapeutic implications as they can be indicative of various clinical situations with diverse underlying aetiologies. It is essential to rule out secondary thrombocytosis before further investigating for primary thrombocytosis. Thrombocytosis warrants thorough investigations and careful clinical correlation.