The relationship between platelet count, sepsis, and survival in pediatric burn patients

T. A. Housinger, C. Brinkerhoff and G. D. Warden
Shriners Burn Institute, Cincinnati, Ohio.

Early identification of sepsis can be difficult in severe burns because of the systemic changes that routinely accompany these burns. This review examined the value of a falling platelet count in predicting the development of sepsis. Thirty-two pediatric patients who sustained lethal burn injuries were compared with 32 patients with similar burns who survived. Daily platelet count was evaluated in conjunction with clinical course. Thirty-one of the 32 non-survivors developed a platelet count less than 0.1 x 10(12)/L. Only 10 of the survivors had a similar occurrence. Platelet count decline preceded other signs of sepsis in all cases. A platelet count below 0.1 x 10(12)/L for more than 4 days was uniformly associated with death. All patients who died succumbed to multisystem organ failure, consistent with sepsis. These results emphasize platelet count as an independent predictor of sepsis and death.