Low platelet counts predict mortality in severe community acquired pneumonia in children under 5 years of age: A hospital based observational study

Abstract

Objective: To assess the association of clinical and common laboratory parameters (haemoglobin, leukocyte and platelet count) with mortality in hospitalized cases with CAP. Methods: A prospective observational study, conducted in a tertiary health institute in Lucknow, Northern India. Included were children between 2 to 59 months admitted with WHO defined severe pneumonia. Excluded were those illness of  ≥14 days, prior hospitalization for same illness and who were on anti-tubercular therapy and having fast breathing due to congenital heart disease. Results: From August 2014 to July 2015, of 196 patients admitted, 152 were included of which 11 (7.2%) expired. On unconditional logistic regression analysis, controlling for abnormal sensorium, cyanosis, and severe acute malnutrition, platelet count <0.7 lac/mm3 on admission predicted mortality (adjusted OR = 10.7, p < 0.03) and had good specificity (95.4%) but low sensitivity (45.5%). Conclusion: Since low platelet count is an independent predictor of mortality in children with severe CAP, it must be estimated routinely in all cases.