背景:急性未分化发热伴血小板减少症是三级护理中心急诊科常见且具有挑战性的临床表现,特别是在热带地区,通常需要及时的评估和管理。该研究旨在探讨英迪拉·甘地医学科学研究所急诊科急性未分化发热伴血小板减少症的临床和病因。巴特那它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。
方法:在这项横断面观察研究中,从21年10月至22年9月,对350例急性未分化发热伴血小板减少症患者进行了一年的分析。先前存在的慢性传染病,肝硬化,和自身免疫性疾病被排除。
结果:所有患者均出现血小板减少,65%的患者的血小板计数低于50,000/微升。血小板减少症的程度与器官功能障碍之间存在关联,震惊,第三个空间损失。Logistic回归分析确定血小板减少症,器官功能障碍,和血小板输注需求是总体结局的重要预测因子。病因组比较显示,细菌组的血小板输注需求更高。
结论:迅速识别和处理急性未分化发热患者的血小板减少症至关重要。血小板减少症,伴随着器官功能障碍和休克,显著影响患者预后。基于病因的量身定制的干预措施至关重要。进一步的研究应集中在急性未分化发热伴血小板减少症的特定病毒病因上。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.