Association of platelet count during the course of admission with mortality in critically Ill children.

Abstract

Objective: To determine the pattern of platelet count during the course of admission in critically ill children and its association with in-hospital mortality. Study Design: Prospective Cohort study. Setting: Department of Pediatric, Abbasi Shaheed Hospital, Karachi, Pakistan. Period: March 2025 to January 2026. Methods: A total of 201 children admitted to PICU for more than 24 hours were included using non-probability consecutive sampling. Demographics, clinical and diagnostic evaluations were performed along with platelets count, and their association with final outcome was determined. IBM-SPSS Statistics, version 26.0 was used for data analysis. P-value < 0.05 was taken as signficant. Results: Among 201 critically ill children, 116 (57.7%) were male, and the median age was 18.0 (6.0–48.0) months. In-hospital mortality occurred in 39 (19.4%), and 162 (80.6%) were discharged. Median PRISM-III score was higher among children with mortality (p<0.001). Low platelets increased from 57 (28.4%) on day-1 to 70 (34.8%) on day-3, with no overall time effect (p=0.704), but distributions differed by outcome on each day (p<0.001). Mortality was associated with inotropes, respiratory support, mechanical ventilation, blood transfusion, sepsis, catheter-related bloodstream infection, aspiration pneumonia, dysglycaemia, acute kidney injury, and longer PICU stay. Conclusion: Serial platelet monitoring during early PICU admission provides clinically useful prognostic information and aligns with infection, organ dysfunction, and escalation of organ support.