Early Warning Score in Febrile Thrombocytopenia: A Prospective Study in a Tertiary Care Center, Erode, Tamilnadu

Background: Fever with thrombocytopenia is a significant clinical presentation, often associated with infectious diseases, hematological disorders, and systemic illnesses. Despite its prevalence, there is a paucity of standardized tools for assessing disease severity and guiding treatment. Objective: This study aimed to evaluate patients presenting with fever and thrombocytopenia, identify predictors of mortality, and develop an early warning scoring system to aid clinical decision-making and improve patient outcomes. Methods: A prospective study was conducted on 100 adult patients admitted with fever and thrombocytopenia at Government Erode Medical College Hospital, Perundurai, over one year. Clinical and laboratory parameters, systemic involvement, and outcomes were assessed. A scoring system was derived based on clinical findings, laboratory results, and systemic involvement. Results: The cohort comprised 55 males and 45 females, with a mean age of 30 years. Key findings included a significant correlation between lower oxygen saturation, elevated respiratory rate, abnormal hematocrit, and worse outcomes. Bleeding manifestations were present in 31% of patients, and 40% required platelet transfusion. Mortality was 13%, predominantly due to multisystem dysfunction. The developed scoring system identified patients at higher risk for adverse outcomes and guided early interventions. Conclusion: This study highlights the clinical importance of assessing febrile thrombocytopenia with a focus on systemic involvement and vital signs. The derived scoring system is an inexpensive, reproducible bedside tool that aids in early prognosis, guiding treatment strategies, and improving patient survival. Further multicenter studies with larger cohorts and extended follow-ups are recommended to validate and refine the scoring system.