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Original Research: LUNG INFECTION |

Thrombocytopenia and Thrombocytosis at Time of Hospitalization Predict Mortality in Patients With Community-Acquired Pneumonia

Mehdi Mirsaeidi, MD, MPH; Paula Peyrani, MD; Stefano Aliberti, MD; Giovanni Filardo, PhD; Jose Bordon, MD, PhD; Francesco Blasi, MD, PhD; Julio A. Ramirez, MD
Author and Funding Information

From the Division of Infectious Diseases, Department of Medicine (Drs Mirsaeidi, Peyrani, Bordon, and Ramirez), University of Louisville; the Division of Infectious Diseases, Department of Medicine (Dr Ramirez), Veterans Affairs Medical Center, Louisville, Kentucky; the Institute of Respiratory Disease (Drs Aliberti and Blasi), University of Milan, Ospedale Maggiore Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Milan, Italy; the Institute for Health Care Research and Improvement (Dr Filardo), Baylor Research Institute; the Department of Statistical Science (Dr Filardo), Southern Methodist University, Dallas, TX; and the Division of Infectious Diseases, Department of Medicine (Dr Bordon), Providence Hospital, Washington, DC.

Correspondence to: Julio Ramirez, MD, Professor of Medicine, University of Louisville, 627 S Preston St, Rm 104, Louisville, KY 40202; e-mail: j.ramirez@louisville.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(2):416-420. doi:10.1378/chest.09-0998
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Background:  Platelets are inflammatory cells with an important role in antimicrobial host defenses. We speculate that an abnormal platelet count may be a marker of severity in patients with community-acquired pneumonia (CAP). The objectives of this study were to evaluate if abnormal platelet count in hospitalized patients with CAP was associated with 30-day mortality and to compare platelet count and leukocyte count as predictors of 30-day mortality.

Methods:  We performed a retrospective cohort study of 500 consecutive patients hospitalized with CAP at the Veterans Hospital of Louisville, Kentucky, between June 2001 and March 2006 to investigate the association of platelet count and leukocyte count with 30-day mortality. Predictor variables were platelet count and leukocyte count. Abnormal platelet count was < 100,000/L (thrombocytopenia) and > 400,000/L (thrombocytosis). The outcome variable was 30-day mortality. To control for potential confounding, a propensity score that incorporated 33 variables was used.

Results:  Platelet count was strongly associated (P = .0009) with 30-day mortality, whereas no association was observed for leukocyte count (P = .5114). High platelet counts resulted in a significantly increased risk of mortality.

Conclusions:  Thrombocytopenia and thrombocytosis are associated with mortality in patients hospitalized with CAP. When evaluating an initial CBC test in patients with CAP, an abnormal platelet count is a better predictor of outcome than an abnormal leukocyte count.

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