An increase in mean platelet volume during admission can predict the prognoses of patients with pneumonia in the intensive care unit: A retrospective study

Abstract

Platelets play an important role in hemostasis, inflammation, and immunity. Mean platelet volume (MPV), considered a marker of platelet function and activation, is associated with increased morbidity and mortality in sepsis, coronary artery disease, and chronic inflammatory disease. However, the clinical characteristics and prognostic significance of MPV changes for patients with pneumonia in the intensive care unit (ICU) have not been investigated. This retrospective study was conducted using data from an operational database of patients admitted to a medical ICU between October 2010 and October 2017. Of 235 adult patients with pneumonia admitted to the ICU, clinical characteristics and in-hospital mortality values were compared according to MPV, ΔMPVday1–2, ΔMPVday1–3, ΔMPVday1–4, and ΔMPVday1–Discharge between those who survived and those who did not. The MPV increased during the first four days for both non-survivors and survivors (P < 0.001). However, repeated measures analysis of variance revealed a significantly higher MPV rate over the first four days in non-survivors than in survivors. Additionally, the ΔMPVday1–2, ΔMPVday1–3, ΔMPVday1–4, and ΔMPVday1–Discharge values were significantly greater in non-survivors than in survivors. For in-hospital mortality, the optimal ΔMPV values were >0.9 fL, P = 0.020; >0.9 fL, P < 0.001; >0.8 fL, P < 0.001; and >1.3 fL, P < 0.001 on day 2, day 3, day 4, and at discharge, respectively. In conclusion, our findings demonstrate that ΔMPV during ICU admission may be used as a prognostic marker of mortality in ICU patients with pneumonia. Repeated MPV measurements throughout hospitalization may improve risk stratification for these patients, which could aid in improving patient outcomes.

Reduced miR-26b Expression in Megakaryocytes and Platelets Contributes to Elevated Level of Platelet Activation Status in Sepsis

“…Larger platelets usually contain more secretory granules, more RNA, and thus become more reactive than their smaller counterparts [39]. Although SELP expression did not significantly correlate with the outcome of sepsis in these patients, increased MPV values also predicted disease prognosis, as reported by others in sepsis with pneumonia [40]. In the presence of an augmented mRNA level that predicts changes in protein expression, higher P-selectin concentration was detected in platelet lysates after 72 h of sepsis onset that could be a result of altered miRNA and mRNA levels in platelets and MKs.…”

“…To examine the contribution of calpain substrate Dicer enzyme in the generation of altered miRNA levels in sepsis, we applied a MK model for sepsis-induced Dicer dysfunction in which 0.3 × 10 6 /mL MEG-01 cells were treated by a specific exogenous calpain 1 and 2 inhibitor, calpeptin (40 µmol/L, Sigma-Aldrich, St. Louis, MO, USA) for 24 h in a similar way as it was performed previously [21,40]. The effect of calpeptin on miRNA expression was assessed in the following settings: vehicle (DMSO); LPS or TNF-α; LPS or TNF-α, together with calpeptin; calpeptin alone as a positive control.…”

High Mean Platelet Volume Associates with In-Hospital Mortality in Severe Pneumonia Patients

“…However, the evidence in pneumonia now is limited and controversial. Two studies showed that increasing MPV may be linked to poor outcomes [11,12], whereas one study conversely showed a decrease [13]. Besides, there is an important difference in platelet biology impacted by sex.…”

Response to the Letter: Mean Platelet Volume to Platelet Count Value May Not Be a Prognostic Marker in Patients with Crimean–Congo Hemorrhagic Fever

“…Lee et al 4 indicated that MPV measurements may be used as a prognostic marker of mortality in intensive care unit patients with pneumonia.…”