A Study of Relationship between Various Platelet Indices and Outcome of Dengue Fever in Pediatric Patients

Background: Dengue fever is a serious public health concern, especially among children in tropical areas. Platelet indices including Platelet Count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (P-LCR) are investigated as potential predictors of disease severity and clinical course. Objective: The current study is an assessment of the relationship between platelet indices and clinical outcomes among paediatric patients diagnosed with dengue fever. Methods: A prospective observational study was carried out at a tertiary care hospital at tumkur Karnataka among 60 paediatric patients (2-15 years) diagnosed with dengue fever according to WHO criteria. The patients were subjected to varying treatment regimens, and clinical parameters like demographic information, symptomatology, and laboratory indicators-such as platelet count, PDW, P-LCR, and Plateletcrit (PCT)were noted. The research followed patients for 8 days, classifying them according to platelet count and PCT values to determine their relationship with indicators of morbidity like the need for fluid therapy, hospital stay, and rates of ICU admission. Statistical methods involved ANOVA, Chi-square tests, and multivariate regression. Results: The cohort included 55% male and 45% female participants with 50% of patients aged 6-10 years, fever was noted in everyone, while 40% displayed warning signs. Platelet count improved density from 1.2 0.3 lakh on Day 1 to reach 3.8 0.5 lakh on Day 8 (p < 0.001) while PDW and P-LCR values decreased significantly. Patients who tested positive for both NS1 and IgM had the most significantly diminished platelet counts (1.0 0.2 lakh) and elevated platelet distribution width (PDW) (16.5% 1.0) and platelet-large cell ratio (P-LCR) (25% 3), indicating severe thrombocytopenia in these patients. Low platelet counts (<1.5 lakh) were significantly correlated with younger age (7.8 2.1 years), increased fluid therapy requirements (500 100 ml), prolonged hospital stay (7.5 1.5 days), and increased ICU admission rates (30%) (p < 0.05). PCT (>0.282%) was significantly correlated only to increased fluid therapy and prolonged hospital stay (p < 0.05); the correlation to ICU admissions was not statistically significant (p = 0.08). Conclusion: This study extends our understanding of platelet indices significantly correlate with the severity of disease in paediatric patients with dengue. Low platelet counts and increased PDW, P-LCR, and PCT are associated with prolonged hospital stay and increased ICU admission rates. These correlate indices provide an important prognostic indices to be used to enable early patient risk stratification and timely intervention to improve patient outcomes.