Increased mean platelet volume in children with sepsis as a predictor of mortality

Abstract

Our aim is to investigate the correlation between the mean platelet volume (MPV) levels and platelet counts of the septic children with 28-day mortality risk. MPV at admission (MPV < sub > adm < /sub > ), MPV at 72 < sup > nd < /sup > hour (MPV < sub > 72h < /sub > ) and the difference between these two parameters (ΔMPV < sub > 72h-adm < /sub > ) and platelet counts were recorded retrospectively. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. One hundred eighty six children were enrolled into the study. The study group had significant higher MPV values than those of control group. There were 156 survivors and 32 nonsurvivors in study group with a mortality rate of 17%. Nonsurvivors had significantly higher MPV < sub > adm < /sub > (p: 0.001), MPV < sub > 72h < /sub > (p: 0.001), ΔMPV < sub > 72h-adm < /sub > (p < 0.001) and lower platelet count (p: 0.002) than survivors. MPVadm (OR 2.39), MPV < sub > 72h < /sub > (OR 4.23), ΔMPV < sub > 72h-adm < /sub > (OR 6.4), platelet count (OR 7.3), and need for mechanical ventilation support (OR 9.76) had significant effect on 28-day mortality risk at logistic regression analysis. At the receiver operating characteristic analysis (ROC) the cutoff values for MPV < sub > adm < /sub > , MPV < sub > 72h < /sub > , and ΔMPV < sub > 72h-adm < /sub > were found to be 9 fL, 9.86 fL, and 0.79, respectively. Kaplan-Meier analysis and log-rank test proved that these cutoff values were significantly associated with the time of survival. Septic children who had high MPV levels at admission and whose MPV levels increased during follow up had higher risk of mortality. With the results of further researches targetting large groups of pediatric patients, MPV < sub > adm < /sub > , MPV < sub > 72h < /sub > , and ΔMPV < sub > 72h-adm < /sub > values can be fast and reliable markers for early diagnosis of sepsis and mortality prediction.

Criteria for Pediatric Sepsis—A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce*

“…Our meta-analysis provides strong support for greater organ dysfunction in nonsurvivors compared with survivors as shown by the pooled estimates for renal dysfunction ( 50 , 64 , 67 , 70 ), multi-organ dysfunction (MODS) ( 23 , 33 , 41 , 50 , 69 , 70 , 93 , 94 ), number of organ dysfunctions ( 28 , 40 , 64 , 83 ), PEdiatric Logistic Organ Dysfunction (PELOD) score ( 23 , 28 , 40 , 44 , 50 , 53 , 55 , 60 , 65 , 72 , 85 ), and PELOD-2 ( 85 , 86 , 95 ). Our meta-analysis also provides strong support for greater illness severity in nonsurvivors compared with survivors as shown by the pooled estimates pediatric Sequential (Sepsis-related) Organ Failure Assessment (pSOFA) ( 50 , 58 , 70 , 95 ) and Sequential (Sepsis-related) Organ Failure Assessment (SOFA) ( 85 , 86 , 95 ), PRISM ( 32 , 43 , 51 , 53 , 55 , 60 – 62 , 64 , 68 , 70 – 72 , 75 , 77 , 81 , 84 , 85 , 88 ), Pediatric Index of Mortality (PIM)-2 ( 79 , 85 ), and PIM-3 ( 23 , 61 , 65 , 85 ) (Supplementary Fig. 7,…”

Correlation of Some RBCs and Platelets Indices with Outcome of Critically Ill Children Admitted to Pediatric Intensive Care Units

“…According to Işgüder et al (13) non survivors showed a considerably lower platelet count than survivors (p-value 0.002). At logistic regression analysis, platelet count (OR 7.3) demonstrated a significant impact on the probability of 28-day mortality risk.…”

Comparative study between complete blood picture indices and presepsin as early prognostic markers in septic shock patients

“…In agreement, Kim et al [20] reported that non-survivors exhibited significant higher baseline and day 3 MPV values. Also, İşgüder et al [33] showed that non-survivors had significant high MPV on admission and 72 h later. MPV in both groups was higher on day 3 than admission; this result is in concordance with study done by Kim et al in which MPV was higher at 72 h than baseline in both non-survivors and survivors [20].…”