Platelet distribution width as a prognostic factor in patients with COPD – pilot study

Abstract

BackgroundPlatelets may actively participate in inflammation in COPD. Platelet distribution width (PDW), a measure of platelets’ volume heterogeneity, may increase in platelets’ activation. We hypothesized that PDW may be a marker of hypercoagulation, which plays a significant role in conditions associated with worse survival of patients with COPD, eg, acute myocardial infarction and other forms of ischemic heart disease.MethodsRetrospective analysis of 79 patients. Variables were compared after grouping patients according to the upper normal limit of PDW, using Welch’s t-tests or Mann–Whitney U, and chi-square tests. Survival in the two groups was compared using the Kaplan–Meier method and Cox proportional hazards regression.ResultsTen patients presented values of PDW above 16 fL, which was the upper limit of normality for our laboratory. Compared to patients with normal PDW, they had lower forced expiratory flow between 25% and 75% of vital capacity (FEF 25–75) – 35% of reference value vs 57% (P=0.003) and peak expiratory flow – 39% vs 54% (P<0.001). The median survival of patients with elevated PDW was 743 days compared to those with normal PDW (1,305 days) (P=0.025). The adjusted HR was 4.59 (95% CI: 1.1, 19.19; P=0.04).ConclusionOur analysis indicates that elevated PDW is associated with reduced survival of patients with COPD. If our data are to be confirmed, PDW may be used as an inexpensive and repeatable prognostic tool in COPD.

Platelet distribution width: a novel prognostic marker in an internal medicine ward

“…Our most interesting finding is the demonstration of prognostic significance of higher values of PDW on admission in internal medicine wards. Higher PDW levels have recently been reported to be associated with increased morbidity and mortality in numerous clinical investigations that focused on patients with critical illness [11,13], and with specific acute and chronic disorders [10,[14][15][16][17][18][19][20][21][22][23]. We observed that PDW values above the cut-off of 16.7% at admission, as well as above the normal range, were associated with an increased risk of mechanical ventilation and death during the current hospitalization, and shortened survival following discharge.…”

“…Increased PDW values have been reported in patients with diabetes mellitus [5], cancer [6,7], and cardiocerebrovascular and respiratory disorders [8][9][10][11][12]. Moreover, higher PDW levels have recently been reported to be associated with increased morbidity and mortality among patients with critical illness [11,13], coronary artery disease [14][15][16][17], cancer [18][19][20][21], pulmonary embolism [10,22], and chronic obstructive pulmonary disease [23]. Most previous studies on the clinical significance of PDW involved patients with specific disorders.…”

Mean Platelet Volume and Platelet Distribution Width in Patients With Obstructive Sleep Apnea Syndrome and Concurrent Chronic Obstructive Pulmonary Disease

“…14 Further evidence suggests that elevated PDW is associated with worse respiratory function and reduced survival in patients with stable COPD. 24,25…”

Comparison of complete blood counts of stable COPD patients at two different altitude in Turkey.

“…14 PDW is expected to be higher in COPD patients compared to healthy people. 14 There are studies showing that PDW is correlated with increasing age and MPV. 15 In our study, there is a reverse finding for PDW.…”