Platelet count monitoring in burn patients
Introduction: Platelets play an important role in severe hemostasis disorders and immune response impairments in burn patients. The aim of this study was platelet count monitoring in burn patients in relation to the severity of burn injury (percentage of total body surface area burned - %TBSA) and disease outcome (survival/death).
Materials and methods: We investigated a total of 68 patients: group A (32 patients with mild burns, 10% TBSA) and group B (36 patients with moderate/severe burns, > 10% TBSA). Platelet count was determined on Sysmex XT-1800i automated hematology analyzer on the 1st, 4th, 7th, 21st and 28th day after burn injury, depending on the length of hospital stay.
Results: Platelet count was significantly different on the 4th and 7th day comparing group A and B according to the severity of injury; platelet count was lower in group B (P < 0.001; P = 0.045). Whenthe 4th day wascompared to the 1st day, a platelet count decrease was observed in both groups, but was significant only in group B. In both groups, a significant increase in platelet count was observed on the 7th day compared to the 4th day, and on the 14th compared to the 7th day. In relation to disease outcome, 56 patients in our study group survived and 12 died. Comparison between surviving and non-surviving patients showed a significant difference throughout the whole period of observation (P < 0.05).
Conclusion:The significant between-group differences observedin platelet count on the 4th and 7th day in relation to severity of injury, as well as the significant decrease in platelet count on the 4th day as compared to the 1st day in patients with moderate/severe burns, suggest the need to increase the frequency of platelet count monitoring in this particular period in order to timely identify the decrease in platelet count. Comparing surviving and deceased patients, a significantly lower platelet count was observed in the group of patients with lethal outcome throughout the whole period of observation, with the exception of the 1st day when platelet count was higher in this group. Despite the between-group differences in platelet count in relation to disease outcome (but similar time-dependent changes in, i.e. increase and decrease) and because of a low number of the examined deceased patients, additional investigations are needed.
Keywords: platelet; burn patient; total body surface area percentage; disease outcome
