Platelet Indices and Their Kinetics Predict Mortality in Patients of Sepsis

In this study we explore the differences in platelet indices and their kinetics between sepsis survivors and non-survivors. A retrospective cohort-study of 97 cases of culture-positive sepsis at a tertiary-care center in North India. Demographics, clinical and laboratory parameters at admission were assessed. Platelet count (PLT), mean-platelet-volume (MPV), platelet-distribution-width (PDW) and plateletcrit (PCT) on admission, and third, fifth and last days of hospitalization were analyzed. Fractional change in platelet indices ( ΔMPV72h,ΔPDW72h, ΔPCT72h, and ΔPLT72h) by day-3 were calculated. Unpaired and paired t-tests were used to compare survivors with non-survivors, and to study the change in platelet indices with time. Logistic regression was used for multivariate analysis. ROC-curves and optimum cut-offs to predict mortality were obtained. There were 64 survivors. Non-survivors had significantly higher ΔMPV72h,ΔPDW72h, day-1 MPV and PDW, and lower ΔPLT72h. MPV and PDW increased, and PLT decreased with time among non-survivors. Trends were reversed in survivors. Only MPV and PDW showed significant change by day-3. Both were independent predictors of mortality on multivariate analysis, alongside ΔMPV72h and ΔPLT72h. On ROC analysis, MPV, PDW, ΔMPV72h,ΔPDW72h and ΔPLT72h effectively predicted mortality. Cut-off for MPV was 10.25 fL (sensitivity  = 93.9%, specificity = 60.9%), and PDW, 12.6% (sensitivity = 84.8%, specificity = 51.6%). A rise in...
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research