Dev Anand, Kumar Abhay, Kumar Santosh, Gunjan Gagan, Singh Siddharth, Arun Nitali
Emergency Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Internal Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2023 Sep 5;15(9):e44719. doi: 10.7759/cureus.44719. eCollection 2023 Sep.
Acute undifferentiated fever with thrombocytopenia is a common and challenging clinical presentation encountered in the emergency departments of tertiary care centers, particularly in tropical regions, often requiring prompt evaluation and management. The study aimed to explore the clinical and etiological profile of acute undifferentiated fever with thrombocytopenia in the Emergency Department of Indira Gandhi Institute of Medical Sciences, Patna. It investigates factors associated with patient outcomes and compares platelet transfusion requirements among different etiological groups.
In this cross-sectional observational study, 350 patients with acute undifferentiated fever with thrombocytopenia were analyzed for one year from October '21 to September '22. Pre-existing chronic infectious diseases, liver cirrhosis, and autoimmune conditions were excluded.
Thrombocytopenia was observed in all patients, with 65% having platelet counts below 50,000/µL. Associations were found between the degree of thrombocytopenia and organ dysfunction, shock, and third space loss. Logistic regression analysis identified thrombocytopenia, organ dysfunction, and platelet transfusion requirement as significant predictors of the overall outcome. Etiological group comparisons revealed higher platelet transfusion requirements in the bacterial group.
Prompt recognition and management of thrombocytopenia in acute undifferentiated fever are vital. Thrombocytopenia, along with organ dysfunction and shock, significantly influence patient outcomes. Tailored interventions based on etiological factors are crucial. Further research should focus on specific viral aetiologies in acute undifferentiated fever with thrombocytopenia.
急性未分化型发热伴血小板减少是三级医疗中心急诊科常见且具有挑战性的临床表现，尤其是在热带地区，常常需要迅速评估和处理。本研究旨在探讨巴特那英迪拉·甘地医学科学研究所急诊科急性未分化型发热伴血小板减少的临床和病因学特征。研究调查了与患者预后相关的因素，并比较了不同病因组之间的血小板输注需求。
在这项横断面观察性研究中，对2021年10月至2022年9月期间的350例急性未分化型发热伴血小板减少患者进行了为期一年的分析。排除既往存在的慢性传染病、肝硬化和自身免疫性疾病。
所有患者均出现血小板减少，65%的患者血小板计数低于50,000/µL。发现血小板减少程度与器官功能障碍、休克和第三间隙丢失之间存在关联。逻辑回归分析确定血小板减少、器官功能障碍和血小板输注需求是总体预后的重要预测因素。病因组比较显示细菌组的血小板输注需求更高。
在急性未分化型发热中迅速识别和处理血小板减少至关重要。血小板减少以及器官功能障碍和休克会显著影响患者预后。基于病因因素的针对性干预至关重要。进一步的研究应聚焦于急性未分化型发热伴血小板减少的特定病毒病因。
