Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.

<h4>Introduction</h4>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.<h4>Objective</h4&...

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Main Authors: Jorge Luis Vélez-Páez, Pedro Legua, Pablo Vélez-Páez, Estefanía Irigoyen, Henry Andrade, Andrea Jara, Fernanda López, Jorge Pérez-Galarza, Lucy Baldeón
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0262356
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author Jorge Luis Vélez-Páez
Pedro Legua
Pablo Vélez-Páez
Estefanía Irigoyen
Henry Andrade
Andrea Jara
Fernanda López
Jorge Pérez-Galarza
Lucy Baldeón
author_facet Jorge Luis Vélez-Páez
Pedro Legua
Pablo Vélez-Páez
Estefanía Irigoyen
Henry Andrade
Andrea Jara
Fernanda López
Jorge Pérez-Galarza
Lucy Baldeón
author_sort Jorge Luis Vélez-Páez
collection DOAJ
description <h4>Introduction</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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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spelling doaj.art-84c36a0e6fa042258ddeca1656483c7b2022-12-22T00:00:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01171e026235610.1371/journal.pone.0262356Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.Jorge Luis Vélez-PáezPedro LeguaPablo Vélez-PáezEstefanía IrigoyenHenry AndradeAndrea JaraFernanda LópezJorge Pérez-GalarzaLucy Baldeón<h4>Introduction</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0262356
spellingShingle Jorge Luis Vélez-Páez
Pedro Legua
Pablo Vélez-Páez
Estefanía Irigoyen
Henry Andrade
Andrea Jara
Fernanda López
Jorge Pérez-Galarza
Lucy Baldeón
Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
PLoS ONE
title Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
title_full Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
title_fullStr Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
title_full_unstemmed Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
title_short Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.
title_sort mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis
url https://doi.org/10.1371/journal.pone.0262356
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