Infectious Diseases Department and Northern Territory Medical Program, Royal Darwin Hospital, Darwin, Australia.
Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia.
Am J Trop Med Hyg. 2019 May;100(5):1085-1087. doi: 10.4269/ajtmh.18-0698.
Thromobocytopenia predicts mortality in patients with melioidosis in Thailand. We analyzed platelet counts in two large cohorts of melioidosis patients in tropical northern Australia to assess utility in a different clinical setting. Admission platelet counts were compared between subgroups of patients with different clinical outcomes. Patients with more severe disease (indicated by bacteremia, septic shock, and death) had significantly lower platelet counts than those with less severe disease. Logistic regression analysis was carried out for potential predictors of mortality among various clinical parameters, and platelet count was shown to be an independent predictor of mortality. Furthermore, in patients critically ill with melioidosis, an increasing platelet count after admission was associated with a significantly greater chance of survival. However, given that most patients with severe disease still had platelet counts within the normal range, platelet count is not a useful biomarker for predicting the severity of melioidosis in a clinical context.
血小板减少症可预测泰国类鼻疽患者的死亡率。我们分析了热带北澳大利亚两个大型类鼻疽患者队列的血小板计数，以评估其在不同临床环境中的应用。我们比较了不同临床结局亚组患者的入院时血小板计数。患有更严重疾病（表现为菌血症、感染性休克和死亡）的患者的血小板计数明显低于患有较轻疾病的患者。对各种临床参数中死亡的潜在预测因素进行了逻辑回归分析，血小板计数是死亡的独立预测因素。此外，在患有类鼻疽的重病患者中，入院后血小板计数增加与生存机会显著增加相关。然而，鉴于大多数患有严重疾病的患者的血小板计数仍在正常范围内，血小板计数并不是预测类鼻疽严重程度的有用生物标志物。
