Admission platelet count and indices as predictors of outcome in children with severe Sepsis: a prospective hospital-based study

Abstract

Background: Sepsis is still one of the main causes of infants and children mortality especially in developing, economically challenged countries with limited resources. Our objective in this study was to determine, the prognostic value of platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) in critically ill infants and children with severe sepsis, as they are readily available biomarkers, that can guide clinicians during managing of severe sepsis. Methods: Sixty children were included; they were diagnosed with severe sepsis according to the international pediatric sepsis consensus conference criteria. At admission to Pediatric intensive care unit, complete blood count with platelet count and parameters (MPV, PDW and PCT) and C-reactive protein (CRP) level were determined for all children. Also, assessment of the Pediatric Risk of Mortality (PRISM III) score was done to all. These children were followed up till discharge from hospital or death. Accordingly, they were grouped into: (1) Survivor group: included 41 children. (2) Non-survivor group: included 19 children. Results: Platelet count and PCT were significantly lower (p < 0.001) and MPV was significantly higher in nonsurvivor than survivors (p = 0.004). MPV/PLT, MPV/PCT, PDW/PLT, PDW/PCT ratios were found to be significantly higher in the non-survivors than survivor (p < 0.001 in all). PCT with sensitivity = 94.74%, was the most sensitive platelet parameter for prediction of death, while MPV/PCT was the most sensitive ratio (sensitivity = 94.7%). Conclusion: Thrombocytopenia, platelet indices and their ratios, especially plateletcrit and MPV/PCT, are readily available, sensitive, prognostic markers, that can identify the severe sepsis patients with poorest outcome.

Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis

“…34,35 Further researches showed that RDW, PDW, and RPR were significantly associated with the prognosis of many diseases, such as cancer, sepsis, and cardiovascular disease. [36][37][38][39] However, there are few reports about the relationship between Nevertheless, some limitations of our study must be considered. First, the soluble interleukin-2 receptor detection was unavailable in our hospital.…”

“…Therefore, red blood cell distribution width and platelet ratio (RPR) have been reported as a useful parameter describing the systemic inflammatory response by a large number of studies 34,35 . Further researches showed that RDW, PDW, and RPR were significantly associated with the prognosis of many diseases, such as cancer, sepsis, and cardiovascular disease 36–39 . However, there are few reports about the relationship between HLH and RDW, PDW, and RPR.…”

Performance of Platelet Mass Index as a Marker of Severity for Sepsis and Septic Shock in Children

“…Platelet count and MPV have been evaluated as prognostic markers in sepsis and septic shock. 9,17 Thrombocytopenia, on the other hand, seems to be independently associated with increased mortality in severe sepsis. Choi et al showed that thrombocytopenia in children with sepsis had an AUC of 0.79 (95% CI: 0.69-0.90).…”

“…6 Platelet volume indices are biomarkers for platelet activation and are associated with systemic inflammation 7 and have been used as inflammatory and prognostic markers in various pathologies. 8,9 These platelet volume indices, such as mean platelet volume (MPV), plateletcrit, and platelet distribution width, can often be rapidly measured by complete blood cell (CBC) count analyzers. 10 Platelet mass index (PMI) is the product of platelet count and MPV.…”

Complete Blood Count Profile and Derived Inflammatory Markers in Children with Severe Acute Malnutrition Seen in Sokoto, North-Western Nigeria

“…Platelets with increased number and size of pseudopodia differ in size, which affects PDW which increases in sepsis [24]. Sayed [25] in a study on admission platelet indices showed PDW was higher in non-survivors of sepsis but not significant, rather plateletcrit (PCT) and MPV/PCT ratio were significantly associated with mortality. Similar findings were also reported by Golwala [26].…”