Thrombocytosis at time of hospitalization is a reliable indicator for severity of CAP patients in ICU

Abstract

BackgroundClinicians have always evaluated the degree of leukocytosis in patients with pneumonia as an indication of systemic inflammatory response and severity of disease. But platelets have been increasingly recognized as inflammatory cells with an important role in host defenses. ObjectiveTo evaluate if abnormal platelet count in hospitalized patients with CAP was associated with severity of CAP comparing it with abnormal leucocytes’ count. MethodsThe study enrolled 66 patients with community acquired pneumonia admitted to respiratory ICU of Ain Shams University and Ain Shams University specialized hospitals. Data were collected from each patient including demographic data, clinical findings, comorbidities, laboratory data, arterial blood gas results, chest radiographic findings; pneumonia severity index (PSI) and CURB-65 were calculated. Simple correlations between variables were examined by calculating Pearson’s product correlation coefficient. Four models of multiple linear regression analysis was performed to study the simultaneous effects of the different data variables on PSI, CURB-65 score, need for mechanical ventilation and length of stay in ICU as dependent variables respectively indicating pneumonia severity. ResultsThere were significant correlations between the following: personal data, clinical findings, arterial blood gas findings, laboratory results, radiological findings and data of severity which are (PSI, PSI class, CURB-65 score, length of stay in ICU, mechanical ventilation) (p<0.001). Thrombocytosis was strongly associated with CAP severity parameters and was more significant than abnormal leucocytic count in predicting the severity of CAP as studied on their effect on PSI, CURB-65 score and need for mechanical ventilation; while leucocytosis was more significant in predicting the length of stay in ICU than thrombocytosis. ConclusionThrombocytosis can be used as a marker of severity in patients with community-acquired pneumonia better than leucocytes’ count.