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Thrombocytosis and Systemic Inflammatory Response Syndrome [SIRS] are Independent Predictors of Venous Thromboembolism [VTE] in Clinically Suspected Patients

Akella Chendrasekhar, MD; Shahniwaz Labana, BS; Trishul Bhagat, BA; Joseph Kim, BS
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Richmond University Medical Center, Staten Island, NY


Chest. 2013;144(4_MeetingAbstracts):555A. doi:10.1378/chest.1702984
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Abstract

SESSION TITLE: Outcomes/Quality Control Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Platelets and inflammation have been shown to be dominant contributors to hypercoagulability in patients at risk for VTE. However data on platelet counts and SIRS in relation to VTE are sparse.

METHODS: We retrospectively reviewed the data on 884 hospitalized adult patients [medical and surgical] suspected of VTE. All patients had venous duplex and Pulmonary Embolism protocol CT [CTPA] performed. We collected demographic data as well as Platelet count, white blood cell count, heart rate, respiratory rate, temperature [as close to the time of venous duplex as possible] in order to determine the presence of SIRS. Patients were divided into VTE positive and negative groups. . The data were analyzed by one-way analysis of variance [ANOVA] and multivariate analysis.

RESULTS: we had 229 patients that were VTE positive [either duplex or CTPA positive] and 652 VTE negative. The platelet count was significantly higher in the VTE positive group [291,450 ± 7,939 versus 241,499 ± 4,705, p=0.0001] VTE positivity was significantly associated with SIRS [32.3 ± 2.7% versus 19.6 ± 1.6%, p=0.0001]. We subsequently grouped our patients by platelet count of ≥ 250,000. Surprisingly, There was no correlation between Platelet count ≥ 250k and the presence of SIRS. Using multivariate analysis, both platelet count of ≥ 250k[p=0.03] and the presence of SIRS [p=0.05] were independently associated with VTE.

CONCLUSIONS: In patients suspected of VTE, Platelet count of ≥ 250k and SIRS were independent predictors of VTE

CLINICAL IMPLICATIONS: In patients with clinical suspicion of VTE, platelet count and the presence of SIRS should be evaluated and if positive empiric therapy for VTE should be initiated while diagnostic testing is undertaken

DISCLOSURE: The following authors have nothing to disclose: Akella Chendrasekhar, Shahniwaz Labana, Trishul Bhagat, Joseph Kim

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