Annals of Tropical Medicine and Public Health

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 10  |  Issue : 6  |  Page : 1572--1574

Is there any correlation between the severity of an injury and thrombocytosis in multiple trauma patients?


Hamideh Akbari1, Alireza Jalali2, Atefeh Abdollahi3, Masoumeh Hosseinpoor1, Hamid Dowlatkhah1,  
1 Department of Emergency Medicine, Jahrom University of Medical Science, Jahrom, Iran
2 Department of Emergency Medicine, Zabol University of Medical Sciences, Zabol, Iran
3 Department of Emergency Medicine, Jahrom University of Medical Science, Tehran, Iran

Correspondence Address:
Hamideh Akbari
Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom
Iran

Abstract

Objective: Trauma is often the result of an overwhelming amount of stress that exceeds one's ability to cope or integrate the emotions involved with that experience. However, trauma differs between individuals according to their subjective experiences. People react to similar events differently. Platelets are acute-phase reactants. Patients and Methods: This is a retrospective study of all patients with trauma admitted to the trauma center. A total of 242 patients with multiple traumas were identified through a prospective registry. The severity of illness was evaluated on the first day using the injury severity score (ISS). The platelet count was checked in all trauma patients at admission time, 24 h later, and after 72 h. Results: The 242 patients with multiple traumas who were in the emergency department of Peymanieh Hospital showed that there was correlation between the severity of injury in multiple trauma patients and a change in the platelet count after 24 h (P < 0.05). The platelet count after 24 h in minor and moderate ISS groups had decreased. However, in critical ISS group patients, the count increased after 24 h. Conclusion: There was a correlation between the severity of the injury and thrombocytosis in multiple trauma patients.



How to cite this article:
Akbari H, Jalali A, Abdollahi A, Hosseinpoor M, Dowlatkhah H. Is there any correlation between the severity of an injury and thrombocytosis in multiple trauma patients?.Ann Trop Med Public Health 2017;10:1572-1574


How to cite this URL:
Akbari H, Jalali A, Abdollahi A, Hosseinpoor M, Dowlatkhah H. Is there any correlation between the severity of an injury and thrombocytosis in multiple trauma patients?. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Aug 20 ];10:1572-1574
Available from: http://www.atmph.org/text.asp?2017/10/6/1572/222674


Full Text



 Introduction



Refractory thrombocytosis or secondary thrombocytosis is defined as an increase in platelet count above 450 × 10 after exposure to stress stimuli. The stress disorders are systemic infections, inflammatory conditions, bleeding, and trauma.

Recent investigations have suggested that responses to traumatic stressors also appear to have a psychological foundation that could result in disorders of immune function and blood cell count.[1] Rises in leukocyte, lymphocyte, and T cell counts, and changes in the cell-mediated immune system have been reported.[2],[3]

Trauma is often the result of an overwhelming amount of stress that exceeds one's ability to cope or integrate the emotions involved with that experience. However, trauma differs between individuals according to their subjective experiences. People react to similar events differently. Platelets are acute-phase reactants.

The purpose of this study was to determine a correlation between severity of trauma and thrombocytosis in multiple trauma patients.[4]

 Patients and Methods



This is a retrospective study of all patients with trauma admitted to the trauma center of Peymanieh Hospital at Jahrom between February 2014 and July 2016. A total of 242 patients with multiple traumas were identified through a prospective registry. The severity of illness was evaluated on the first day using the injury severity score (ISS). This was based on the presence or absence of cardiac, respiratory, hepatic, renal, neurologic, and hematologic disorders and/or infections.[5] Other variables were recorded as well. These include age, sex, site of the major injury, and specific injury.

Patient-specific data were abstracted into an Excel worksheet. The data elements included age, gender, mechanism of injury, injury sustained and operative procedures, admission vitals (heart rate, systolic blood pressure, Glasgow coma score), laboratory values (serial platelet counts), ISS, and outcomes such as length of stay in hospital or Intensive Care Unit.[6]

The platelet count has been checked in all trauma patients at admission time, 24 h later, and after 72 h. Thrombocytosis was defined as a platelet count <450 × 10. We evaluated patients with serial platelet counts.

The inclusion criteria were all patients with multiple traumas who were admitted to Peymanieh Hospital's emergency department with each ISS.

The exclusion criteria were patients with multiple traumas who had underlying disorders that might affect the platelet count, such as any hematologic disorders.

 Results



Of the 242 patients with multiple traumas who were at the emergency department in Peymanieh Hospital, 85% were men and 15% were women. The average age of the patients was 32.45 ± 18.43 years.

Here, 46.8% were admitted with 58.4% of them having surgery and about 82.7% getting a brain CT scan. About 54.7% of them had a critical ISS [Table 1].{Table 1}

The result of the t-test showed that in patients with a minor or moderate ISS, the platelet count decreased after 24 h (P P [7] Our examination found that thrombocytosis occurs in most patients with a critical ISS.

The majority of these patients developed delayed thrombocytosis. This delayed group was more severely injured and required a significantly greater number of surgical interventions.[6]

 Conclusion



In our study, thrombocytosis appeared to be a marker related to the outcome. Trauma patients who subsequently developed thrombocytosis had, on average, a higher predicted risk of death at admission.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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