Effect Of Platelet Count Trends On Bleeding Risk And Transfusion Requirements In Dengue Patients

Abstract

Objective: To determine the association between platelet count trends, coagulation parameters, and bleeding risk in hospitalized patients with dengue infection.

Place and Duration of Study: Department of Medicine, Nishter Hospital, Multan, Pakistan; conducted over one year from March 2023 to March 2024.

Study Design: Cross-sectional study.

Methodology: A total of 113 patients with confirmed dengue infection were enrolled using non-probability consecutive sampling. Data were collected on platelet counts, prothrombin time (PT), activated partial thromboplastin time (APTT), liver enzymes (ALT, AST), demographic variables, and bleeding manifestations. Platelet count trends (increasing, decreasing, stable) were analyzed along with bleeding outcomes. Statistical analysis included unadjusted and adjusted odds ratios

(ORs) with 95% confidence intervals (CIs), chi-square tests for categorical variables, and t-tests for continuous variables. Logistic regression was used to identify independent predictors of bleeding.

Results: Bleeding events were observed in 38.1% of patients. Platelet counts <30,000/µL were significantly associated with bleeding (adjusted OR: 5.74; 95% CI: 2.38–13.88; p < 0.001). Prolonged PT was also significantly linked with bleeding (p = 0.009). However, platelet trends did not show a statistically significant association with bleeding (p = 0.157). No significant differences were observed in bleeding risk based on age, gender, or ALT/AST levels. A weak but statistically significant correlation was noted between age and ALT (r = 0.21, p = 0.025).

Conclusion: Absolute platelet count <30,000/µL and prolonged PT are independent predictors of bleeding in dengue patients. Platelet trends were not predictive of bleeding, emphasizing the clinical utility of absolute thresholds in decision-making. These findings have significant implications for resource-limited settings like Pakistan, where simple laboratory markers can guide effective clinical management.