Clinical outcomes of prophylactic platelet transfusion in patients with dengue: A retrospective study of patients at a tertiary care hospital in Karachi.

OBJECTIVE To determine the benefit of prophylactic platelet transfusion on clinical outcomes in patients with dengue fever. METHODS The retrospective cohort study was conducted at Patel Hospital, Karachi, and comprised record of patients fulfilling World Health Organisation's diagnostic criteria for dengue between 2009 and 2015. We excluded patients with known auto-immune thrombocytopenia, isolated infection with a pathogen other than dengue virus, drug-induced thrombocytopenia and patients requiring therapeutic transfusion. SPSS 21 was used for data analysis. RESULTS Of the 639 dengue patients, 209(32.7%) were transfused platelets (group 1) while 430(67.3%) were not (group 2). There was a significant difference in minor bleeding episodes (65(31.1%) in the transfused group vs. 59(13.7%) in the non-transfused group; p=0.000). Similarly, 4(1.9%) patients died in group 1vs. 1(0.2%) in group 2 (p=0.024). The mean cost of hospital stay was Rs26,733±5,780 in group 1 vs. Rs5,266±3,627 in group 2 (p=0.000). CONCLUSIONS Prophylactic transfusion in dengue patients provided little or no clinical benefit in preventing bleeding complications, and substantially increased medical costs.

[1]  Y. Leo,et al.  Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients , 2016, PLoS neglected tropical diseases.

[2]  J. Ahmed,et al.  Dengue knowledge and its management practices among physicians of major cities of Pakistan. , 2015, JPMA. The Journal of the Pakistan Medical Association.

[3]  I. Rafique,et al.  A retrospective analysis of dengue fever case management and frequency of co-morbidities associated with deaths , 2014, BMC Research Notes.

[4]  J. Akram,et al.  Effectiveness of Platelet Transfusion in Dengue Fever: A Randomized Controlled Trial , 2013, Transfusion Medicine and Hemotherapy.

[5]  L. Lum.  Handbook for Clinical Management of Dengue , 2012 .

[6]  Nagarekha Kulkarni.  Study on the effectiveness of transfusion program in dengue patients receiving platelet transfusion , 2012 .

[7]  P. Pallavi,et al.  Unfurling the Rationale Use of Platelet Transfusion in Dengue Fever , 2011, Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion.

[8]  M. R. Khanani,et al.  DENGUE IN PAKISTAN: Journey from a Disease free to a Hyper Endemic Nation , 2011 .

[9]  K. Mumtaz,et al.  Outbreak of dengue fever in Karachi 2006: a clinical perspective. , 2009, JPMA. The Journal of the Pakistan Medical Association.

[10]  V. Lee,et al.  Lack of efficacy of prophylactic platelet transfusion for severe thrombocytopenia in adults with acute uncomplicated dengue infection. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  V. Raina,et al.  Role of platelet transfusion in the management of dengue patients in a tertiary care hospital , 2007, Asian journal of transfusion science.

[12]  R. Chaudhary,et al.  Transfusion support to Dengue patients in a hospital based blood transfusion service in north India. , 2006, Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis.

[13]  S. Sharma,et al.  Dengue: current trends and challenges--an Indian perspective. , 2004, The Journal of the Association of Physicians of India.

[14]  N. Salahuddin,et al.  An epidemic of Dengue fever in Karachi--associated clinical manifestations. , 1997, JPMA. The Journal of the Pakistan Medical Association.