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BACKGROUND Platelets have important modulatory effects on inflammatory and immune-mediated pathways. Thrombocytopenia is a critical condition that is frequently encountered in the intensive care unit (ICU) and increases mortality. This retrospective study of 472 patients admitted to the ICU with acute exacerbation of chronic obstructive pulmonary disease (COPD) aimed to evaluate thrombocytopenia and mean platelet volume (MPV) with prognosis and patient mortality. MATERIAL AND METHODS A total of 472 patients diagnosed with COPD according to GOLD criteria and hospitalized in the tertiary ICU between 1 April 2018 and 11 May 2021 were included in the study. Platelets were calculated by the impetance method and MPV was simultaneously calculated based on the platelet histogram. Patients with platelet count ≤100×109/L and >100×109/L and patients with MPV values <7 fl, 7-11 fl, and >11fl were compared in terms of mortality and prognosis. RESULTS The mortality rate in COPD patients with thrombocytopenia was high, at 61.5%. Thrombocytopenia (P=.002), high MPV (P=.006) Acute Physiology and Chronic Health Evaluation-2 (APACHE-II) score (P=.025), length of stay (LOS) in the ICU (P=.009), mechanical ventilation duration (P<.001), leukocytosis (P<.001), high Sequential Organ Failure Assessment (SOFA) score (P<.001), LOS in the hospital (P=.035), and hypoalbuminemia (P<.001) were significantly associated with mortality. CONCLUSIONS Thrombocytopenia, high MPV, high APACHE-II and SOFA scores, LOS in the ICU and hospital, duration of mechanical ventilation, leukocytosis, and hypoalbuminemia predict mortality in COPD patients. Since infection-sepsis, hypoalbuminemia, and hypoxia can worsen this situation, ensuring early infection control, providing albumin support, and preventing hypoxia contribute significantly to reducing thrombocytopenia and mortality.
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Unidades de Cuidados Intensivos , Volúmen Plaquetario Medio , Enfermedad Pulmonar Obstructiva Crónica , Trombocitopenia , Humanos , Enfermedad Pulmonar Obstructiva Crónica/sangre , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Femenino , Masculino , Pronóstico , Volúmen Plaquetario Medio/métodos , Trombocitopenia/sangre , Anciano , Estudios Retrospectivos , Persona de Mediana Edad , Recuento de Plaquetas/métodos , APACHE , Tiempo de Internación , Plaquetas/metabolismo , Mortalidad HospitalariaRESUMEN
BACKGROUND: Thrombocytopenia is defined as a decreased number of platelets in the circulating blood as a result of hypo-proliferation in marrow or peripheral destruction of platelets. Several diagnostic methods have been proposed to discriminate the underline cause of thrombocytopenia. Recent studies showed that mean platelet volume (MPV) could be used for differential diagnosis of immune thrombocytopenic purpura (ITP). Thus, we aimed to investigate the diagnostic accuracy of MPV for differential diagnosis of ITP from hypo-productive thrombocytopenia. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (PRISMA). The study protocol was registered on PROSPERO with the reference number CRD42023447789. Relevant published studies that were published up to April 10, 2023, in peer-reviewed journals were searched on electronic different databases. The methodological quality of the included studies was appraised using the quality assessment of diagnostic accuracy studies 2 (QADAS-2) tool. The pooled weight mean difference (WMD) of MPV between the ITP group and hypo-productive group was analyzed using a random-effects model meta-analysis. Relevant data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA 11.0 and Meta-disc 1.4 software. Publication bias was evaluated using Deek's funnel plot asymmetry test. RESULTS: A total of 14 articles were included in this systematic review and meta-analysis. The comparison of MPV between groups revealed that the pooled mean value of MPV increased significantly in ITP patients compared to patients with hypo-productive thrombocytopenia (WMD = 2.03; 95% CI, 1.38-2.69). The pooled sensitivity and specificity of MPV in differentiating ITP from hypo-productive thrombocytopenia were 76.0% (95% CI: 71.0%, 80.0%) and 79.0% (95% CI: 75.0%, 83.0%), respectively. The summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR)using the random effects model were 3.89 (95% CI: 2.49, 6.10) and 0.29 (95% CI: 0.18, 0.46), respectively. CONCLUSION: MPV can be used to discriminate ITP from hypo-productive thrombocytopenia. It can possess large advantages as it is noninvasive, simple, quick, inexpensive, easy to perform, reliable, and routinely generated by automated cell counters.
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Púrpura Trombocitopénica Idiopática , Trombocitopenia , Humanos , Púrpura Trombocitopénica Idiopática/diagnóstico , Volúmen Plaquetario Medio/métodos , Recuento de Plaquetas/métodos , Trombocitopenia/diagnóstico , PlaquetasRESUMEN
Las plaquetas son fragmentos citoplasmáticos anucleados derivados de los megacariocitos que presentan función central, tanto en procesos fisiológicos como la hemostasia, así como también en procesos patológicos como la inflamación, la ateroesclerosis. El tamaño de las plaquetas, medido como volumen medio de plaquetas, es un marcador de reactividad plaquetaria, que proporciona información importante sobre el curso y pronóstico de una variedad de afecciones inflamatorias. El estudio de este marcador se ha utilizado como pronóstico en enfermedades cardiovasculares, preeclampsia y en la púrpura trombocitopénica. El objetivo de este trabajo es revisar los conceptos actuales basados en la evidencia científica relacionados con el volumen plaquetario medio e insistir en su evaluación y significado en la práctica clínica cotidiana(AU)
Platelets are enucleated cytoplasmic fragments derived from megakaryocytes, which have a central function, both in physiological processes such as hemostasis, as well as in pathological processes such as inflammation, atherosclerosis. Platelet size, measured as mean volume of platelets, is a marker of platelet reactivity, providing important information on the course and prognosis of a variety of inflammatory conditions. The study of this marker has been used as a prognostic in cardiovascular diseases, preeclampsia and in thrombocytopenic purpura. The objective of this paper is to review the current concepts based on scientific evidence related to the mean platelet volume and to insist on its evaluation and meaning in daily clinical practice(AU)
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Humanos , Masculino , Femenino , Púrpura Trombocitopénica/diagnóstico , Enfermedades Cardiovasculares , Aterosclerosis , Volúmen Plaquetario Medio/métodos , Procesos PatológicosRESUMEN
AIM: to investigate whether the MAPH score, which is a new score that combines blood viscosity biomarkers such as mean platelet volume (MPV), total protein and hematocrit, can be used to predict thrombus burden in ST-segment elevation myocardial infarction (STEMI) patients. METHODS: A total of 473 consecutive patients with STEMI were included in the study. Intracoronary tirofiban/abciximab infusion was applied to patients with thrombus load ≥3 and these patients (n = 71) were defined as the patient group with high thrombus load. MPV, age, hematocrit and total protein values of the patients were recorded. High shear rate (HSR) and low shear rate (LSR) were calculated from total protein and hematocrit values. Cut-off values were determined for high thrombus load by using Youden index, and score was determined as 0 or 1 according to cut-offs. The sum of the scores was calculated as the MAPH score. RESULTS: The mean age of the patients included in the study was 59.6 ± 12.6 (n = 354 male, 74.8%). There was no difference between the groups in terms of gender, HT and DM (P = .127, P = .402 and P = .576, respectively). In the group with high thrombus load; total protein, MPV and hematocrit values were higher (P < .001, P = .001 and P = .03, respectively). Comparison of receiver operating characteristic (ROC) curve analysis revealed that the MAPH score had better performance in predicting higher thrombus load than both other self-containing parameters and HSR and LSR. CONCLUSION: The MAPH score may be a new score that can be used to determine thrombus burden in STEMI patients.
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Trombosis Coronaria/complicaciones , Vasos Coronarios/diagnóstico por imagen , Medición de Riesgo/métodos , Infarto del Miocardio con Elevación del ST/sangre , Biomarcadores/sangre , Viscosidad Sanguínea , Angiografía Coronaria , Trombosis Coronaria/sangre , Trombosis Coronaria/epidemiología , Femenino , Humanos , Incidencia , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Intervención Coronaria Percutánea , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/epidemiología , Infarto del Miocardio con Elevación del ST/cirugía , Trombosis , Tomografía de Coherencia Óptica/métodos , Turquía/epidemiología , Ultrasonografía IntervencionalRESUMEN
INTRODUCTION: Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients. OBJECTIVE: Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis. METHODS: A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome. RESULTS: The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively. CONCLUSIONS: MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.
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Plaquetas/patología , Choque Séptico/mortalidad , Choque Séptico/patología , Anciano , Biomarcadores/metabolismo , Ecuador , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Puntuaciones en la Disfunción de Órganos , Recuento de Plaquetas/métodos , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Curva ROC , Choque Séptico/metabolismoRESUMEN
BACKGROUND: Mean platelet volume (MPV), an essential component of the complete blood count (CBC) indices, is underutilized in common practice. In recent years, MPV has drawn strong interest, especially in clinical research. During inflammation, the MPV has a higher value because of platelet activation. OBJECTIVES: To verify whether high MPV values discovered incidentally in healthy naïve patients indicates the development or the presence of cardiovascular risk factors, particularly metabolic syndrome and pre-diabetes. METHODS: A cohort study was used to assess the diagnostic value of high MPV discovered incidentally, in naïve patients (without any known cause of an abnormal high MPV, greater than upper limit of the normal range, such as active cardiovascular diseases and metabolic syndrome). RESULTS: The mean MPV value in the patient group was 12.3 femtoliter. There was a higher incidence of metabolic syndrome in our research group than in the general population and a non-significant tendency of pre-diabetes. Family doctors more frequently meet naïve patients with high MPV than a hospital doctor. The results of our study are more relevant for him, who should know the relevance of such a finding and search for a hidden pre-diabetes or metabolic syndrome. CONCLUSIONS: High MPV values discovered incidentally in healthy naïve subjects suggest the development or the presence of cardiovascular risk factors, particularly metabolic syndrome and pre-diabetes. No statistically significant association was found between MPV and the presence of cardiovascular disease.
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Plaquetas , Volúmen Plaquetario Medio/métodos , Síndrome Metabólico , Activación Plaquetaria/fisiología , Estado Prediabético , Enfermedades Asintomáticas , Plaquetas/patología , Plaquetas/fisiología , Factores de Riesgo Cardiometabólico , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hallazgos Incidentales , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Médicos de Familia , Estado Prediabético/sangre , Estado Prediabético/diagnósticoRESUMEN
BACKGROUND: Venous thromboembolism (VTE) is a serious disease, which demands a fast accurate diagnosis to begin suitable treatment. It presents a major problem in the emergency department (ED), and its confirmation requires adequate evaluation. OBJECTIVES: To evaluate a potential role of mean platelet volume (MPV) in differentiating VTE from other potential diagnosis in patients with suspected VTE. METHODS: We conducted a retrospective case-controlled study of 440 consecutive patients who presented to the ED of our hospital with clinical VTE, but only 316 with proven VTE. A control group was composed of patients (124) who presented with clinical VTE but without proven VTE. We checked the MPV value in all 440 patients and the correlation with VTE occurrence in the study group vs. control group. RESULTS: Statistical analysis of the acquired results indicated that MPV value could not aid in determining the difference of real VTE vs. patients with VTE-like clinical picture presenting to the ED. We found an inverse correlation between MPV value and proven VTE, in contrast to most researchers who have studied the same issue. CONCLUSIONS: Although MPV can be a useful diagnostic marker in many diseases, we found no definite association between low MPV and VTE.
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Diagnóstico Precoz , Volúmen Plaquetario Medio/métodos , Tromboembolia Venosa , Estudios de Casos y Controles , Diagnóstico Diferencial , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Resultados Negativos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Tiempo de Tratamiento , Tromboembolia Venosa/sangre , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiologíaRESUMEN
BACKGROUND: Patients with microsatellite instability-high (MSI-H) colorectal cancer (CRC) generally have a better prognosis and a more effective immune response than patients with microsatellite stable (MSS) CRC. Moreover, activated platelets play a crucial role in modulating innate immune cells. Mean platelet volume (MPV) is an indicator of platelet activation. This study is to examine the association between MPV and MSI status in CRC. METHODS: We collected the clinical and pathological variables of 424 CRC patients diagnosed at the Harbin Medical University Cancer Hospital from January 2018 to December 2018. Associations between MPV levels and MSI status were examined. Propensity score matching (PSM) was performed to reduce the possibility of selection bias. RESULTS: 424 CRC patients were divided into low-MPV group and high-MPV group according to the optimal cut-off value of MPV. 131 high-MPV patients were matched to low-MPV counterparts in a 1:1 ratio by propensity score matching. As MPV levels increased, the percentage of patients with MSI-H reduced. Furthermore, compared with MSS group, the MSI-H group had a significantly lower MPV levels (p= 0.003 after matching). In addition, logistic regression analysis identified reduced MPV as an independent risk factor for MSI-H in CRC patients after controlling for other potential parameters. CONCLUSION: Lower MPV is associated with MSI-H subtype of CRC. Further study on MPV in MSI-H CRC is warranted.
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Neoplasias Colorrectales/sangre , Volúmen Plaquetario Medio/métodos , Anciano , Neoplasias Colorrectales/patología , Femenino , Humanos , Masculino , Inestabilidad de Microsatélites , Puntaje de PropensiónRESUMEN
Objectives: Changes in hematological parameters are becoming evident as important early markers of COVID-19. Type 2 Diabetes Mellitus (T2DM) has been shown to be associated with increased severity of COVID-19. In this study, we aim to explore the various hematological variables in COVID-19 positive patients with T2DM, so as to act early and improve patient outcomes.Methods: Medical e-records of seventy adult patients with T2DM who were COVID-19 positive have been analyzed in this retrospective cohort study. Demographic, clinical and laboratory parameters for these patients were examined.Results: Of the seventy patients with T2DM, 48.88% had poorly controlled diabetes. 70.69% were pyrexial, 56.25% were tachycardic and 38.58% were asymptomatic on presentation. Amongst the hematological parameters, anemia was seen in 10% of males and 15.38% of females. 20% had a high red-blood-cell-distribution-width (RDW). 7.27% had thrombocytosis and 3.64% had thrombocytopenia. 73.3% had a high platelet-distribution-width (PDW) and 44.44% had an increased mean-platelet-volume (MPV). 16.36% were neutropenic and 16.67% had lymphocytopenia.Conclusion: Diabetic COVID-19 positive patients have been shown to have prominent manifestations of the hemopoietic-system with varied hematological profiles. Recognizing the implications of these variables early in primary-care, can help clinicians aid management decisions and dictate early referral to secondary-care services, to help improve prognosis.
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COVID-19/sangre , Diabetes Mellitus Tipo 2/sangre , Enfermedades Hematológicas/sangre , Atención Primaria de Salud/tendencias , Adulto , Anemia/sangre , Anemia/diagnóstico , Anemia/epidemiología , Biomarcadores/sangre , COVID-19/diagnóstico , COVID-19/epidemiología , Estudios de Cohortes , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Índices de Eritrocitos/fisiología , Femenino , Enfermedades Hematológicas/diagnóstico , Enfermedades Hematológicas/epidemiología , Humanos , Masculino , Volúmen Plaquetario Medio/métodos , Volúmen Plaquetario Medio/tendencias , Persona de Mediana Edad , Recuento de Plaquetas/métodos , Recuento de Plaquetas/tendencias , Atención Primaria de Salud/métodos , Estudios Retrospectivos , Trombocitopenia/sangre , Trombocitopenia/diagnóstico , Trombocitopenia/epidemiologíaRESUMEN
COVID-19 has a worldwide distribution; however, there is no effective diagnosis marker, especially for the mild-type COVID-19. The purpose of the current study was to identify parameters for mild-type COVID-19. We retrospectively analyzed a single-center data of patients with mild COVID-19. Forty patients diagnosed with COVID-19 were enrolled. Peripheral blood indices between the admission and discharge times were collected and analyzed. The platelet distribution width (PDW) was shown to be an indicator of significant change. The receiver operating characteristic curve for PDW was 0.7; the sensitivity and specificity for PDW were 82.5% and 55.0%, respectively. Therefore, a potential diagnostic value of PDW for mild-type COVID-19 was demonstrated.
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Prueba de COVID-19/métodos , COVID-19/diagnóstico , Volúmen Plaquetario Medio/métodos , Adulto , Anciano , COVID-19/sangre , COVID-19/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Estudios RetrospectivosRESUMEN
OBJECTIVES: This study aims to investigate the diagnostic and prognostic role of mean platelet volume (MPV) and MPV/platelet (PLT) ratio in primary malignant bone tumors. PATIENTS AND METHODS: We retrospectively investigated patients with primary malignant bone tumors between January 2010 and January 2019 and included 109 patients (69 males, 40 females; mean age: 41.9±17.9 years; range 15 to 86 years) in the study. A total of 107 healthy volunteers (61 males, 46 females; mean age: 47 years; range 19 to 61 years) who donated blood to the blood center of our hospital in 2019 formed the control group. Demographic features, MPV, PLT counts, mortality, and recurrence records of the patients were obtained from archives. RESULTS: Of the 109 patients, 11 were diagnosed with Ewing's sarcoma, 52 with chondrosarcoma, and 46 with osteosarcoma. The tumor was located on the right in 56% of patients and on the lower extremity in 59.6% of patients. The recurrence rate was 41.3% in the patient group. Of the 109 patients, 17 (15.6%) resulted in exitus at follow-up. The mean PLT value of the patient group was significantly higher than the control group (289,440 vs. 247,299, p<0.001). The median MPV and MPV/PLT ratios were statistically significantly lower in the patient group than in the control group (8.3 vs. 10.5, p<0.001 and 0.032 vs. 0.043, p<0.001, respectively). The MPV, PLT count, and MPV/PLT ratio were not associated with mortality and recurrence. The cut-off value was determined as >9.25 fL for MPV (sensitivity=74%, specificity=85%, positive likelihood ratio=4.96, positive predictive value=83.4%, and negative predictive value=76.5). CONCLUSION: Consequently, MPV and MPV/PLT ratios can be used as a diagnostic support parameter in primary malignant bone tumors, but have no prognostic value.
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Neoplasias Óseas , Volúmen Plaquetario Medio/métodos , Recurrencia Local de Neoplasia , Recuento de Plaquetas/métodos , Adulto , Neoplasias Óseas/sangre , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/mortalidad , Femenino , Humanos , Extremidad Inferior/patología , Masculino , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/epidemiología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Turquía/epidemiologíaRESUMEN
Although migraine is a neurological disorder known for its long, physiopathology remains unclear. The aim of this study was to investigate the levels of hematological parameters and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR) and neutrophil/monocyte ratio (NMR) used as inflammatory markers in patients diagnosed with migraine. This retrospective study was performed with 250 patients and 215 healthy volunteers who were followed up in the neurology outpatient clinic with the diagnosis of migraine. Hematological parameters, C-reactive protein (CRP), NLR, PLR, LMR, NMR ratios were compared in the patient and control groups. Patients with migraine were grouped according to loss of function, the severity of pain and aura. 20.8% of patients in the mean age of 36.37 ± 8.683 had migraine with aura. We found that NMR values in migraine with aura (MWA) were significantly higher than in the control group. CRP, PLR and NMR values in migraine without aura (MWOA) were significantly higher than in the control group. Mean platelet volume (MPV) and platelet values were higher in patients with MWA and MWOA compared to the control group but did not show a statistically significant difference. We believe that these results support systemic inflammation in patients with migraine and the presence of a continuous inflammatory process even in periods without attacks. More comprehensive studies are needed to clarify the underlying pathophysiology that may guide the follow-up and treatment of the disease.
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Plaquetas/metabolismo , Linfocitos/metabolismo , Trastornos Migrañosos/sangre , Trastornos Migrañosos/diagnóstico , Neutrófilos/metabolismo , Adulto , Biomarcadores/sangre , Biomarcadores/metabolismo , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
INTRODUCTION: In this single center retrospective cohort study, 784 patients with sepsis were enrolled and followed up for at least 30 days. The selected endpoint was an all-cause mortality event. METHOD: The relationship between MPV-CV + NEU%-CV and all-cause mortality (in-hospital and 30-day) was analyzed by categorizing the patients into four groups according to MPV-CV and NEU%-CV values. For in-hospital mortality, a significantly higher risk of mortality was observed in patients with an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% than in patients of the other groups (P < 0.001). After adjustment for age, sex, body mass index (BMI), infection site, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, use of vasoactive drugs, mechanical ventilation and renal replacement therapy (RRT), hematocrit, albumin, procalcitonin (PCT), and lactate, logistic regression analysis revealed that an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% was an independent predictive factor for in-hospital mortality [adjusted model: odds ratio (OR) = 4.48, 95% CI = 2.92-6.88, P = 0.001]. RESULTS: After adjustment for age, sex, BMI, infection site, APACHE II score, SOFA score, hematocrit, albumin, PCT, lactate, and the use of vasoactive drugs, mechanical ventilation, and RRT, Cox proportional-hazards regression model revealed that an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% was an independent predictive factor for 30-day mortality [adjusted model 1: hazard ratio (HR) = 7.69, 95% CI = 4.15-14.24, P < 0.001; adjusted model 2: HR = 4.07, 95% CI = 2.50-6.62, P < 0.001]. CONCLUSION: The combination of MPV-CV and NEU%-CV provides a good prognostic value and is a strong independent predictor of short-term clinical outcomes in patients with sepsis. An MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% is significantly associated with adverse short-term clinical outcomes.Trial registration number is XJTU2AF2016LSY-04, the registration date is December 2018.
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Infecciones , Volúmen Plaquetario Medio , Neutrófilos , Sepsis , APACHE , Análisis de Varianza , China/epidemiología , Femenino , Mortalidad Hospitalaria , Humanos , Infecciones/complicaciones , Infecciones/diagnóstico , Unidades de Cuidados Intensivos/estadística & datos numéricos , Recuento de Leucocitos/métodos , Recuento de Leucocitos/estadística & datos numéricos , Masculino , Volúmen Plaquetario Medio/métodos , Volúmen Plaquetario Medio/estadística & datos numéricos , Persona de Mediana Edad , Puntuaciones en la Disfunción de Órganos , Atención al Paciente/métodos , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Sepsis/sangre , Sepsis/etiología , Sepsis/mortalidadRESUMEN
BACKGROUND: Detailed temporal analyses of complete (full) blood count (CBC) parameters, their evolution and relationship to patient age, gender, co-morbidities and management outcomes in survivors and non-survivors with COVID-19 disease, could identify prognostic clinical biomarkers. METHODS: From 29 January 2020 until 28 March 2020, we performed a longitudinal cohort study of COVID-19 inpatients at the Italian National Institute for Infectious Diseases, Rome, Italy. 9 CBC parameters were studied as continuous variables [neutrophils, lymphocytes, monocytes, platelets, mean platelet volume, red blood cell count, haemoglobin concentration, mean red blood cell volume and red blood cell distribution width (RDW %)]. Model-based punctual estimates, as average of all patients' values, and differences between survivors and non-survivors, overall, and by co-morbidities, at specific times after symptoms, with relative 95% CI and P-values, were obtained by marginal prediction and ANOVA- style joint tests. All analyses were carried out by STATA 15 statistical package. MAIN FINDINGS: 379 COVID-19 patients [273 (72% were male; mean age was 61.67 (SD 15.60)] were enrolled and 1,805 measures per parameter were analysed. Neutrophils' counts were on average significantly higher in non-survivors than in survivors (P<0.001) and lymphocytes were on average higher in survivors (P<0.001). These differences were time dependent. Average platelets' counts (P<0.001) and median platelets' volume (P<0.001) were significantly different in survivors and non-survivors. The differences were time dependent and consistent with acute inflammation followed either by recovery or by death. Anaemia with anisocytosis was observed in the later phase of COVID-19 disease in non-survivors only. Mortality was significantly higher in patients with diabetes (OR = 3.28; 95%CI 1.51-7.13; p = 0.005), obesity (OR = 3.89; 95%CI 1.51-10.04; p = 0.010), chronic renal failure (OR = 9.23; 95%CI 3.49-24.36; p = 0.001), COPD (OR = 2.47; 95% IC 1.13-5.43; p = 0.033), cardiovascular diseases (OR = 4.46; 95%CI 2.25-8.86; p = 0.001), and those >60 years (OR = 4.21; 95%CI 1.82-9.77; p = 0.001). Age (OR = 2.59; 95%CI 1.04-6.45; p = 0.042), obesity (OR = 5.13; 95%CI 1.81-14.50; p = 0.002), renal chronic failure (OR = 5.20; 95%CI 1.80-14.97; p = 0.002) and cardiovascular diseases (OR 2.79; 95%CI 1.29-6.03; p = 0.009) were independently associated with poor clinical outcome at 30 days after symptoms' onset. INTERPRETATION: Increased neutrophil counts, reduced lymphocyte counts, increased median platelet volume and anaemia with anisocytosis, are poor prognostic indicators for COVID19, after adjusting for the confounding effect of obesity, chronic renal failure, COPD, cardiovascular diseases and age >60 years.
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COVID-19/sangre , Biomarcadores/sangre , Recuento de Células Sanguíneas , COVID-19/inmunología , Estudios de Cohortes , Demografía/métodos , Índices de Eritrocitos/inmunología , Femenino , Humanos , Inflamación/sangre , Inflamación/inmunología , Recuento de Leucocitos/métodos , Estudios Longitudinales , Linfocitos/inmunología , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Neutrófilos/inmunología , Pronóstico , Ciudad de Roma , SobrevivientesRESUMEN
BACKGROUND: Postoperative atrial fibrillation (PoAF) is the most common arrhythmic complication detected after coronary artery bypass grafting (CABG). It is associated with increased morbidity and mortality, especially in elderly patients. Mean platelet volume (MPV) shows the activation of platelets effective in the inflammatory and thrombotic process. The purpose of the present study was to investigate the relations between the preoperative MPV levels and development of PoAF in isolated CABG in elderly patients. METHODS: A total of 103 elderly patients (aged ≥ 65 years), who underwent isolated CABG and were at preoperative sinus rhythm, were included in the study. Patients who did not have PoAF were identified as Group 1 (N = 74), and those with PoAF were identified as Group 2 (N = 29). RESULTS: PoAF incidence was 28.2%. Preoperative MPV level was 8.41 ± 1.13 fL in Group 1, and 9.28 ± 1.00 fL in Group 2. The difference was statistically significant (P < .001). Multivariate logistic regression analysis revealed that age, preoperative hemoglobin, and preoperative MPV were independent predictive factors for PoAF development (OR [odds ratio]: 1.149, 95% CI [confidence interval]: 1.043-1.265, P = .005; OR: 1.334, 95% CI: 1.013-1.758, P = .040; OR: 2.103, 95% CI: 1.324-3.339, P = .002, respectively). The cut-off value for MPV as the predictor of PoAF development was found to be 8.43 (sensitivity: 82.8% and specificity: 55.4%). CONCLUSION: This study showed that MPV levels are associated with PoAF development in elderly patients, and other independent predictive factors include age and preoperative hemoglobin levels for POAF development.
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Fibrilación Atrial/sangre , Plaquetas/metabolismo , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/cirugía , Volúmen Plaquetario Medio/métodos , Complicaciones Posoperatorias/sangre , Anciano , Anciano de 80 o más Años , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/etiología , Enfermedad de la Arteria Coronaria/sangre , Electrocardiografía , Femenino , Estudios de Seguimiento , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Pronóstico , Estudios RetrospectivosRESUMEN
During the evaluation of the DxH 900 hematology analyzer (Beckman Coulter, Miami, FL), we noted that some patient samples produced a false positive white blood cell (WBC) flag, neutrophil blasts (NE-blast), despite the absence of abnormal cells. We investigated whether storage time or anticoagulants such as K2- or K3-ethylenediaminetetraacetic acid (EDTA) would affect complete blood count (CBC) tests on the DxH 900. Sixty-four whole blood samples were collected in K3-EDTA tubes, and 44 were simultaneously drawn in K2-EDTA tubes. Samples were tested at the following two intervals: within 30 min of collection (0 min) and after an additional 30 min of roller-mixing at room temperature (30 min). WBC differential dataplots in 0-min K3-EDTA tubes showed a mixed cell population between lymphocytes and neutrophils in 22 patients presenting the NE-blast flag. All 22 samples revealed normal WBC differential dataplots after 30 min of roller-mixing. The significantly lower mean neutrophil volume in specimens of 0-min K3-EDTA tubes than those of 0-min K2-EDTA, 30-min K2-EDTA and 30-min K3-EDTA tubes appear to be the cause of the false flag. Unlike blood cell counts, mean platelet volume (MPV) was significantly higher at 30 min using both EDTA tubes than that at 0 min. In conclusion, K3-EDTA can produce a false positive flag, NE-blast, on the DxH 900. MPV increases over time irrespective of EDTA salt type.
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Anticoagulantes/química , Recuento de Células Sanguíneas/normas , Ácido Edético/química , Enfermedades Hematológicas/sangre , Hematología/normas , Recuento de Leucocitos/normas , Adulto , Anciano , Anciano de 80 o más Años , Automatización de Laboratorios , Plaquetas/patología , Niño , Reacciones Falso Positivas , Femenino , Enfermedades Hematológicas/diagnóstico , Hematología/instrumentación , Hematología/métodos , Humanos , Linfocitos/patología , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Neutrófilos/patologíaRESUMEN
BACKGROUND: An increasing number of studies in recent years have identified mean platelet volume (MPV) as a predictive marker for neonatal sepsis. However, most of these studies focused on single regions, and therefore, the findings remain inconclusive. We, in this study, aimed to evaluate the potential of MPV as a biological indicator of neonatal sepsis through a systematic review and meta-analysis. METHODS: We searched PubMed, the Cochrane Library, Embase, and WanFang database for articles on MPV and neonatal sepsis, published from January 1, 1990 to December 31, 2018. We included 11 studies on 932 neonates with sepsis in this meta-analysis. RESULTS: The overall meta-analysis showed that MPV was significantly higher in patients with neonatal sepsis compared with healthy controls. Subgroup analysis revealed that the type of diagnostic criteria, analyzer, analyte, and controls used in the studies affected the difference in MPV between patients and healthy controls. CONCLUSION: MPV was significantly higher in the neonatal sepsis group compared to the control group. Therefore, in clinical practice, MPV could be used as an indicator for the early diagnosis of neonatal sepsis.
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Volúmen Plaquetario Medio/métodos , Sepsis Neonatal/diagnóstico , Pronóstico , Biomarcadores/análisis , Biomarcadores/sangre , Distribución de Chi-Cuadrado , Humanos , Recién Nacido , Volúmen Plaquetario Medio/normas , Sepsis Neonatal/sangre , Valor Predictivo de las PruebasRESUMEN
AIMS: Diabetes mellitus (DM) is associated with significant morbidity and mortality. The disease severity in 2019 novel coronavirus (Covid 19) infection has varied from mild self-limiting flu-like illness to fulminant pneumonia, respiratory failure and death. Since DM and Covid 19 infection are closely associated with inflammatory status, mean platelet volume (MPV) was suggested to be useful in predicting Covid infection onset. This study aimed to evaluate the diagnostic role of MPV in Covid patients with diabetes. METHODS: A total of 640 subjects (160 Covid patients with type 2 diabetes, 160 healthy controls, 160 patients with non-spesific infections and 160 Covid patients without type 2 diabetes) enrolled in the study. RESULTS: MPV was significantly higher (11.21 ± 0.61 fL) as compared to the results from the last routine visits of the the same individuals with diabetes (10.59 ± 0.96 fL) (p = 0.000). CONCLUSIONS: MPV could be used as a simple and cost-effective tool to predict the Covid infection in subjects with diabetes in primary care.
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Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatología , Volúmen Plaquetario Medio/métodos , Neumonía Viral/diagnóstico , COVID-19 , Estudios de Casos y Controles , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Diabetes Mellitus Tipo 2/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/epidemiología , Neumonía Viral/virología , SARS-CoV-2 , Turquía/epidemiologíaRESUMEN
Abstract Background: The presence of nucleated red blood cells (NRBCs) and increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) in peripheral circulation are associated with poorer prognosis in patients with acute coronary disease. Objective: We developed a scoring system for in-hospital surveillance of all-cause mortality using hematological laboratory parameters in patients with acute myocardial infarction (AMI). Methods: Patients admitted for AMI were recruited in this prospective study. Exclusion criteria were age younger than 18 years, glucocorticoid therapy, cancer or hematological diseases and readmissions. NRBCs, MPV and NLR were measured during hospitalization. The scoring system was developed in three steps: first, the magnitude of the association of clinical and laboratory parameters with in-hospital mortality was measured by odds ratio (OR), second, a multivariate logistic regression model was conducted with all variables significantly (p < 0.05) associated with the outcome, and third, a β-coefficient was estimated by multivariate logistic regression with hematological parameters with a p < 0.05. Results: A total of 466 patients (mean age were 64.2 ± 12.8 years, 61.6% male) were included in this study. A hematological scoring system ranging from 0 to 49, where higher values were associated with higher risk of in-hospital death. The best performance was registered for a cut-off value of 26 with sensitivity of 89.1% and specificity of 67.2%, positive predictive value of 26.8% (95% CI: 0.204 - 0.332) and negative predictive value of 97.9% (95% CI: 0.962 - 0.996). The area under the curve for the scoring system was 0.868 (95% CI: 0.818 - 0.918). Conclusions: Here we propose a hematological scoring system for surveillance tool during hospitalization of patients with acute myocardial infarction. Based on total blood count parameters, the instrument can evaluate inflammation and hypoxemia due to in-hospital complications and, consequently, predict in-hospital mortality.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Índice de Severidad de la Enfermedad , Enfermedad de la Arteria Coronaria/diagnóstico , Mortalidad Hospitalaria , Infarto del Miocardio/diagnóstico , Pronóstico , Biomarcadores , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad , Eritrocitos , Volúmen Plaquetario Medio/métodos , Infarto del Miocardio/mortalidadRESUMEN
BACKGROUND: Venous thromboembolism (VTE) is a common complication of cancer. This study aimed to evaluate immature platelet fraction (IPF), mean platelet volume (MPV), P-selectin, D-dimer, and thrombin generation (TG) as predictive biomarkers for VTE and further the improvement of existing risk assessment models (RAMs). METHODS: A prospective, observational, exploratory study was conducted on ambulatory cancer patients with indication for systemic chemotherapy. Baseline RAMs included the Khorana-, Vienna Cancer, Thrombosis-, Protecht-, ONKOTEV-, and Catscore. IPF, MPV, P-selectin, D-dimer, and TG were analysed at baseline and 3-month follow-up. RESULTS: We enrolled 100 patients, of whom 89 completed the follow-up. Frequent tumour types were breast (30%), gastric (14%), gynaecological (14%), and colorectal (14%) cancer. Ten of the 89 patients (11.2%) developed VTE. The highest VTE rate was observed in patients with cholangiocarcinoma (3/5; 60%). Baseline D-dimer levels but not IPF, MPV, or P-selectin were associated with the risk of developing VTE (HR 6.9; p = 0.021). None of the RAMs showed statistical significance in predicting VTE. Peak thrombin and endogenous thrombin potential were lower in patients who developed VTE. Biomarker changes between baseline and follow-up were not associated with VTE risk. CONCLUSIONS: VTE risk was well predicted by baseline D-dimer levels. Adding D-dimer could improve existing RAMs to better identify patients who may benefit from primary VTE prophylaxis. The VTE risk among patients with cholangiocarcinoma should be further evaluated.