Pattern of Platelet and Blood Component Transfusion among Children at a tertiary care Hospital: A Clinical Cross-Sectional Study

Platelet and Blood Component Transfusion among Children in Dengue

Abstract

Background:
Dengue is a major public health problem in tropical countries and frequently presents with thrombocytopenia, leading to widespread use of prophylactic platelet transfusion. However, the appropriateness of platelet transfusion in pediatric dengue remains controversial. The present study aimed to assess the pattern of platelet transfusion and hematological profile, and to evaluate the relationship between platelet count and hemoglobin levels among pediatric dengue patients.

Methods:A descriptive observational study was conducted in the pediatric dengue unit of a tertiary care hospital in Firozabad, Uttar Pradesh, from September to November 2021. A total of 212 clinically suspected cases (?15 years) were enrolled using purposive sampling; 202 laboratory-confirmed dengue cases were analyzed. Clinical features, hematological parameters, and transfusion practices were recorded. Data were analyzed using SPSS version 20.0. Continuous variables were summarized as mean ± SD and categorical variables as frequencies and percentages. Normality was assessed using the Shapiro–Wilk test. Spearman rank correlation was applied to assess the relationship between platelet count and hemoglobin. A p value <0.05 was considered statistically significant.

Result: Among 202 confirmed cases, dengue fever, dengue hemorrhagic fever, and dengue shock syndrome accounted for 89.6%, 12.3%, and 1.8% respectively. Fever (95.5%) and bleeding (22.8%) were the most common manifestations. Platelet transfusion was required in 22 (11%) patients, while only 2.5% required packed red cell transfusion. All patients with platelet count <20,000/µL received transfusion, whereas 44.4% and 13% of patients with platelet counts of 20,000–50,000/µL and 50,000–100,000/µL respectively also received transfusion. Platelet count showed a skewed distribution, while hemoglobin remained relatively stable. A statistically significant moderate negative correlation was observed between platelet count and hemoglobin (Spearman r = ?0.326, 95% CI: ?0.448 to ?0.193, p <0.0001).

Conclusion:

Platelet transfusion was required in a minority of paediatric dengue cases and was not consistently associated with bleeding manifestations. The inverse relationship between platelet count and haemoglobin suggests haemoconcentration rather than blood loss in dengue infection. Judicious use of platelet transfusion based on clinical indications rather than platelet count alone is recommended to avoid unnecessary transfusion.