Prognostic impact of platelet distribution width in patients with Crimean-Congo hemorrhagic fever

Abstract

Platelet distribution width (PDW) is a readily available blood test involving calculations performed by automated blood analyzers. Crimean-Congo hemorrhagic fever (CCHF) may exhibit a severe profile with fatal hemorrhaging or else present with a mild clinical process. The purpose of our study was to investigate the importance of PDW in CCHF patients and its clinical prognostic value. This study was conducted with patients with CCHF. Patients were divided into two groups on the basis of presence or absence of bleeding. Demographic characteristics, clinical findings, PDW, and other laboratory tests were recorded onto forms. A total of 423 patients were included. Hemorrhaging was observed in 27.9% during hospitalization. PDW on the first day of hospitalization was 17.2 ± 0.9% in the hemorrhagic patients and 17.1 ± 0.6% in the cases without hemorrhage (P = 0.290). On the third day of hospitalization, PDW was 17.6 ± 0.8% in the hemorrhagic patients and 17.0 ± 0.7% in the cases without hemorrhage (P < 0.001). At a third-day PDW level cut-off point of 17.1%, AUROC was 0.677, sensitivity 65.5%, specificity 54.6%, PPV 35.5%, and NPV 80.6%. A one-unit raise in third day PDW stepped up the probability of bleeding in patients with CCHF 3.45-fold at logistic regression analysis. This study shows that PDW is a parameter that may be used to determine disease severity. This parameter may be at least as useful as platelet count in helping clinicians identify severe cases. Early identification of cases with a severe course will make it possible to provide early planning of modalities such as intensive care support. J. Med. Virol. 88:1862-1866, 2016. © 2016 Wiley Periodicals, Inc.

Evaluation of Platelet Activity Markers in Prognostic Value of Children with Crimean-Congo Hemorrhagic Fever

“…Yilmaz et al demonstrated PDW levels had significantly higher in adult patients with hemorrhagic CCHF compared with adult patients with nonhemorrhagic CCHF. 12 This situation may be due to different age groups and the severity of the study patients from ours.…”

“…MPV, PDW, and MPM are markers of PLT activation and have been demonstrated to be a sign of inflammation, and these parameters can be obtained from the routine CBC test. 4,6,11,12,[16][17][18][19] MPV and PDW, most commonly used measure of PLT dimension, are usually ignored by the clinicians. 5,11 A study by Ekiz et al reported that MPV values were significantly increased in adult patients with CCHF compared with the controls.…”

Platelet Distribution Width at First Day of Hospital Admission in Patients with Hemorrhagic Fever with Renal Syndrome Caused by Hantaan Virus May Predict Disease Severity and Critical Patients’ Survival

“…MPV represents the average size of platelets in the blood. An increase in PDW and MPV suggests an increased range of platelet size and increased average diameter of the platelets, respectively, due to swelling, destruction, and immaturity [ 12 , 13 , 15 – 21 ]. PCT is the ratio of total platelets in the blood.…”

“…Decreased PLT count was shown to precede acute kidney failure in patients with Puumala virus infections [ 10 ], and PLT count was an independent predictor of severe HFRS [ 11 ] and critically ill patients in intensive care unit (ICU) [ 12 ]. In addition, PDW, MPV, P-LCR, and PCT are associated with platelet activation and function and have recently been shown to be useful markers for predicting occurrence and prognosis of certain inflammatory diseases and vascular diseases, such as Crimean-Congo hemorrhagic fever [ 13 ], sepsis [ 14 ], pulmonary embolism [ 15 ], ascitic fluid infection [ 16 ], obstructive sleep apnea [ 17 ], Crohn's disease [ 18 ], and coronary artery disease [ 19 ]. It is well known that platelet parameters are routinely tested on HFRS patients in hospitals almost every day.…”

Platelet distribution width (PDW) data of patients with nasal polyposis: is it important for clinical severity?

“…[11] PDW gives information about the inflammatory processes of some diseases. [13,14] In the present study, we examined the relation between nasal polyps and PDW retrospectively in 99 patients who underwent endoscopic sinus surgery for nasal polyposis. The measurement of PDW is very easy and practical for several minutes with the result of CBC parameters of the autoanalyzer.…”