Prognostic Significance of Thrombocytopenia and Mean Platelet Volume in COPD Patients with Acute Exacerbations in ICU Settings.
Med Sci Monit
; 30: e944946, 2024 Jul 09.
Article
en En
| MEDLINE
| ID: mdl-38980833
ABSTRACT
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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trombocitopenia
/
Enfermedad Pulmonar Obstructiva Crónica
/
Volúmen Plaquetario Medio
/
Unidades de Cuidados Intensivos
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Med Sci Monit
Asunto de la revista:
MEDICINA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Turquía
Pais de publicación:
Estados Unidos