title: Clinical characteristics and prognostic significance of changes in platelet count in an internal medicine ward.
abstract: BACKGROUND
  The clinical characteristics and prognostic significance of changes in platelet count (PC) during hospitalization in internal medicine wards have not been well investigated.
  
  
  METHODS
  Demographic, clinical and laboratory data were collected from 345 patients admitted to an internal medicine ward. Following discharge, all-cause mortality was recorded. These data were compared, according to deltaPC (PC on discharge minus PC on admission): group 1 (drop in PC, deltaPC -50×10(9)/l), group 2 (no significant PC changes, deltaPC up to 50×10(9)/l) and group 3 (rise in PC, deltaPC +50×10(9)/l).
  
  
  RESULTS
  Groups 1, 2 and 3 comprised 64 (18.5%), 200 (58%) and 81 (23.5%) patients, respectively. Patients from group 3 were younger, more likely admitted for infection and less likely for cardiovascular disorder, and less often presenting with coronary artery disease, complex nursing care and thrombocytosis on admission or thrombocytopenia on discharge than patients from groups 1 and 2. Mean platelet volume was higher in group 2 on admission and lower in group 3 on discharge. During a median follow-up of 25 months, 146 (42.3%) of 345 patients died. The survival rate was higher for group 3 (65.4%) than for groups 1 (45.3%) and 2 (58.5%), p=0.003. In the entire cohort, each 100×10(9)/l increment of deltaPC was a powerful predictor of lower mortality (p=0.03, relative risk=0.83, 95% confidence interval=0.71-0.98).
  
  
  CONCLUSIONS
  Increased PC throughout hospitalization was associated with better prognosis than a drop or blunted rise in PC. The assessment of PC changes in an internal medicine ward may provide useful prognostic information.
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Miriam
authors: M
authors: Shteinshnaider
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Dana
authors: D
authors: Barchel
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Dorit
authors: D
authors: Almoznino-Sarafian
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Irma
authors: I
authors: Tzur
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Neli
authors: N
authors: Tsatsanashvili
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Muhareb
authors: M
authors: Swarka
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
authors: Natan
authors: N
authors: Cohen
authors: Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel. Electronic address: internal6@asaf.health.gov.il.
authors: Oleg
authors: O
authors: Gorelik
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007388:Internal Medicine; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013921:Thrombocytopenia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D013922:Thrombocytosis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality
keywords: Hospitalization; Mortality; Platelets; Prognosis; Thrombocytopenia; Thrombocytosis