Abstract
THROMBOCYTOSIS IN THE SURGICAL WARD KING HUSSEIN MEDICAL CENTER, AMMAN/JORDAN

Nazih Abualsheikh MD*, Nabeeha Abbasi MD, Sohaib Almomani MD, Osama Rabadi MD, Majdi Alsoudi MD, Anas Rabadi MD, Mohammad Obeidat MD

ABSTRACT

Background: Thrombocytosis can occur following a wide variety of surgicalprocedures. The purpose of this study is to assess the platelet count in patients admitted to the surgical ward after major surgeries of two major surgical disciplines; ENT & Breast surgeries and define if post-surgery thrombocytosis is attributed to poor outcomes including the risk of DVT. Methods: Platelet count (PLTs), Hemoglobin (Hb), red blood cell count (RBC), fibrinogen and D-dimer were assessed on admission and at discharge after major surgeries. Thrombocytosis was considered to have occurred when platelet count was greater than or equal to 450 × 109/L. All patients with thrombocytosis had ultrasonography to assess for DVT occurrence. The patients were also divided into “young” and “old” groups according to an age cut-off of 75 years to study potential age-related differences. The study was done in King Hussein Medical Center, a well-known tertiary medical center in the Middle East region. The study was conducted over a six months period and data were retrieved from medical records. The study was approved by the hospital ethic committee and written approval consents were obtained. Results: Two hundred and twenty patients were included to be studied and102 were enrolled for having post surgical thrombocytosis. Of the 102, 27(26.5%) were males and 75(73.5%) were females. The mean age of the study group was 72 ± 15. Of the females, 64 underwent bilateral mastectomy with axillary clearanceand 11 underwentradical neck dissection. Of the males, 26 underwent radical neck dissection and 1 underwent total laryngectomy. The young age group included 35 patients and the old age group included 67 patients. 40 patients (39.2% of the total) had a platelet count of 470-495 x109/L and 62 patients (60.8% of the total) had a platelet count of more than 500 x 109/L, of which 15(14.7% of the total) had very high platelet count above 600 x 109/L. Levels of fibrinogen and Ddimer were also elevated. No subject had a single episode of DVT. Clinical outcome was not affected by the platelet count. Clinical improvement and shorter hospital stay length were observed in young compared to old people to whom a lower Hb level correlated to a rather slower clinical improvement. Conclusion: Thrombocytosis was not uncommon in patients after major ENT and Breast surgeries, but no subject developed DVT. Platelet count increase did not affect the outcome, rather, higher age and a lower hemoglobin level correlated with poorer clinical outcome.

Keywords: Platelets; Thrombocytosis; Clinical outcome; Deep venous thrombosis.


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