ISSN:
1432-1238
Keywords:
Key words Meningococcal disease
;
Prognosis
;
Disseminated intravascular coagulation
;
Platelets
;
Tumour necrosis factor
;
Lactate
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective: To determine the value of the platelet count at admission for the assessment of the severity of disease in acute meningococcal infections. Design: Retrospective and prospective, descriptive patient study. Setting: University Hospital Intensive Care Unit (ICU). Patients: All patients (n = 92) with acute meningococcal disease from 1985 to 1997, who arrived at the ICU within 12 h after hospital admission and had more than one platelet count during the first 12 h. Measurements and results: After admission, platelets dropped in 95 % of the patients. At admission, 2/41 (5 %) of the non-hypotensive patients and 13/51 (25 %) of the hypotensive patients had platelets fewer than 100 × 109/l. During the following 12 h, these percentages increased to 15 % and 71 %, respectively. Fatalities had, at admission, a median platelet count of 111 × 109/l (range, 19–302 × 109/l), whereas the nadir, occurring at median 7.0 h (range, 1.3–12 h), was 31 × 109/l (range, 12–67 × 109/l). Plasma TNF, measured shortly after admission, correlated better with the platelet nadir (r = − 0.65, p 〈 0.0001) than with the platelet count at admission. Similarly, serum lactate correlated better with the platelet nadir. Conclusions: As platelets drop after admission, the use of the platelet count at admission for the assessment of the prognosis in acute meningococcal disease may be misleading. Frequently repeated platelet counts are a better tool for evaluating the severity of disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001340050538
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