Platelet counts of adults upon acute hospital admission to internal medicine units are a predictor of mortality

  • Guillaume MoulisEmail author
  • Christian Fynbo Christiansen
  • Bianka Darvalics
  • Ina Trolle Andersen
  • Henrik Toft Sørensen
  • Mette Nørgaard
Original Article


The objective of this cohort study was to examine the association between platelet counts upon acute hospitalization and mortality. The study included all adults in North and Central Denmark Regions with a first acute admission to an internal medicine unit during 2006–2012, categorized by first platelet count within +/−24 hours of admission. We assessed the association between platelet count and in-hospital, 30-day, 90-day, and 365-day mortality using age- and sex-adjusted Cox models. We also stratified analyses by presence/absence of comorbidity and performed additional analyses restricted to patients with a primary discharge diagnosis of cardiovascular disease or infection. Among the 274,148 study patients, the 1-year mortality was 12.6%. The association between platelet count and mortality took the form of an asymmetric U-shaped curve. For 30-day mortality, hazard ratios (HRs) were 5.24 (95% CI: 4.60–5.97) for platelet count < 50 × 109/L and 2.50 (95% CI: 2.33–2.69) for platelet count ≥ 500 × 109/L, compared with a normal platelet count (150–400 × 109/L). A slightly increased risk of mortality was observed for platelet counts < 200 × 109/L and ≥ 250 × 109/L. A similar pattern was observed for 30-day, 90-day, and 365-day mortality and in all subgroups except patients with a primary discharge diagnosis of infection. In this case, patients with a platelet count between 150 × 109/L and 199 × 109/L had the lowest mortality. Platelet counts in adults upon acute hospital admission to internal medicine units, including counts within the normal range, are a predictor of mortality.


Platelet count Mortality Acute hospitalization 



To conduct this study, GM received grants from the Foundation for the Development of Internal Medicine in Europe (FDIME, linked to the European Federation of Internal Medicine), from the Institut Servier, and from Toulouse University Hospital (CHU de Toulouse).

Authors’ contributions

GM, MN, CFC, and HTS designed the study; GM, BD, and ITA made the data management and the statistical analyses; GM, MN, CFC, and HTS wrote the manuscript. All the authors critically reviewed the manuscript and gave final approval for submission.

Compliance with ethical standards

In accordance with Danish law, we obtained permission from the Danish Data Protection Agency for this study (Record no. 2015-57-0002, Aarhus University record no. 2016-051-000001/396).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2019_3855_MOESM1_ESM.docx (3.9 mb)
ESM 1 (DOCX 3960 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Clinical Epidemiology, Institute of Clinical MedicineAarhus University HospitalAarhusDenmark

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