Thrombocytopenia

Gadó, Klára; Domján, Gyula

doi:10.1556/oh.2014.29822

Cited by 7 publications

(4 citation statements)

References 59 publications

(52 reference statements)

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“…Under pathophysiological conditions, any factor which could inhibit PLT regeneration, increase their activation or accelerate their death once overwhelming the capacity of self-regulation will cause changes in both PLT count and morphology and thus results in a change in PLT indices. [ 13 ] Researches have shown that activation of the coagulation system, severe infection, trauma, systemic inflammatory reaction syndrome and thrombotic diseases could all result in changes in PLT indices. Reduction in PLT has been proved to be one of the independent risk factors for ICU patients.…”

Section: Discussionmentioning

confidence: 99%

Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients

Zhang

Cui

Diao

et al. 2015

Chinese Medical Journal

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Background:Decreased platelet (PLT) count is one of the independent risk factors for mortality in intensive care unit (ICU) patients. This study was to investigate the relationship between PLT indices and illness severity and their performances in predicting hospital mortality.Methods:Adult patients who admitted to ICU of Changzheng Hospital from January 2011 to September 2012 and met inclusion criteria were included in this study. Univariate analysis was used to identify potential independent risk factors for mortality. Multiple logistic regression analysis was used to calculate adjusted odds ratio for mortality in patients with normal or abnormal PLT indices. The relationship between PLT indices and illness severity were assessed by the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores or sequential organ failure assessment (SOFA) scores in patients with normal and abnormal PLT indices. The performances of PLT indices in predicting mortality were assessed by receiver operating curves and diagnostic parameters. The survival curves between patients with normal and abnormal PLT indices were compared using Kaplan–Meier method.Results:From January 2011 to September 2012, 261 of 361 patients (204 survivors and 57 nonsurvivors) met the inclusion criteria. After adjustment for clinical variables, PLT count <100 × 1012/L (P = 0.011), plateletcrit (PCT) <0.108 (P = 0.002), mean platelet volume (MPV) >11.3 fL (P = 0.023) and platelet distribution width (PDW) percentage >17% (P = 0.009) were identified as independent risk factors for mortality. The APACHE II and SOFA scores were 14.0 (9.0–20.0) and 7.0 (5.0–10.5) in the “low PLT” tertile, 13.0 (8.0–16.0) and 7.0 (4.0–11.0) in the “low PCT” tertile, 14.0 (9.3–19.0) and 7.0 (4.0–9.8) in the “high MPV” tertile, 14.0 (10.5–20.0) and 7.0 (5.0–11.0) in the “high PDW” tertile, all of which were higher than those in patients with normal indices. Patients with decreased PLT and PCT values (all P < 0.001), or increased MPV and PDW values (P = 0.007 and 0.003, respectively) had shortened length of survival than those with normal PLT indices.Conclusions:Patients with abnormally low PLT count, high MPV value, and high PDW value were associated with more severe illness and had higher risk of death as compared to patients with normal PLT indices.

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Section: Discussionmentioning

confidence: 99%

Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients

Zhang

Cui

Diao

et al. 2015

Chinese Medical Journal

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“…9 In critical patients, platelet count and morphology of platelets also change, causing alterations in platelet indices. 22,23 Increased PDW levels have been observed in several conditions. 11,12,24 In a retrospective study, low platelet count, high MPV value, and high PDW value were shown to be associated with more severe disease and a higher risk of mortality.…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Platelet Distribution Width and Platelet Distribution Width to Lymphocyte Ratio in Predicting Severity and Outcomes in Patients with Snakebite

Köse

Akdeniz

Babuş

et al. 2021

Wilderness & Environmental Medicine

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Introduction-Tissue damage, inflammatory response, and hematologic abnormalities may occur in snakebite envenomation. This study aimed to evaluate the predictive ability of platelet distribution width (PDW) and platelet distribution width to lymphocyte ratio (PDWLR) in the severity and outcome of envenomation in patients with snakebites in the emergency department (ED).Methods-All adult patients admitted to the ED after a snakebite were retrospectively evaluated. Patients were classified according to the severity of envenomation. The relationship between the PDW and PDWLR and envenomation severity and patient outcomes was analyzed. Multivariate logistic regression analysis was performed to determine the predictors of severe envenomation. Results were presented as 95% CIs with odds ratios. Statistical significance was accepted at P<0.05.Results-Envenomation was classified as none/minimal in 42 patients and moderate/severe in 29. PDW and PDWLR were significantly higher in the moderate/severe group (P=0.016 and P<0.001, respectively). Cut-off values of 16.5 for PDW and 6.15 for PDWLR were related to more severe envenomation (area under the curve 0.67, 95% CI 0.55-0.78 and area under the curve 0.85, 95% CI: 0.74-0.92, respectively). Blood product replacement, thrombocytopenia, hematologic abnormality, advanced local findings, compartment syndrome/fasciotomy, antivenom dosing, and moderate/ severe envenomation were associated with PDWLR >6.15 (P<0.05). In multivariate analysis, PDWLR (odds ratio 1.19 [95% CI 1-1.4]; P=0.04) was an independent predictor of severe envenomation.Conclusions-Higher PDW and PDWLR were associated with severe envenomation in patients with snakebites in the ED. PDWLR may be used as a predictor of severe envenomation and adverse outcomes.

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“…Most individuals are asymptomatic if their platelet count is 50 × 10 9 /L or higher (Gauer and Braun, 2012). Patients with a platelet count below 50 × 10 9 /L are more prone to spontaneous bleeding (i.e., mucosal, gastrointestinal, genitourinary, and intracranial bleeding), which is considered as a hematologic emergency (Stasi, 2012; Gado and Domjan, 2014). There are several causes of thrombocytopenia, including infection, malignancy, autoimmune disease, liver disease, disseminated intravascular coagulation, drugs, pregnancy, and coagulopathy (Smock and Perkins, 2014).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Avatrombopag in Patients With Thrombocytopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Huang

et al. 2019

Front. Pharmacol.

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Background: Avatrombopag is a novel oral, nonpeptide thrombopoietin receptor agonist (TPO-RA). A few studies have shown that avatrombopag is effective against thrombocytopenia. However, no systematic review has been conducted on the efficacy and safety of avatrombopag. Therefore, the aim of this study was to comprehensively assess the efficacy and safety of avatrombopag patients with thrombocytopenia. Methods: Databases including Medline, PubMed, Embase, the Cochrane Library and ClinicalTrials.gov were searched for randomized controlled trials that compared avatrombopag with placebo in patients with thrombocytopenia. The deadline was March 2019. Results: In total, 743 patients were analyzed in five clinical trials. Patients treated with avatrombopag achieved higher platelet response (OR: 17.71, 95% CI [11.01 to 28.48], p < 0.00001) than with placebo. Avatrombopag produced an absolute increment in platelet count (WMD: 31.13%, 95% CI [22.27 to 39.99], p < 0.00001) unlike the placebo. In addition, the incidence of serious adverse events (RR: 1.18, 95% CI [0.72 to 1.93], p = 0.51) and deaths (RR: 0.93, 95% CI [0.19 to 4.45], p = 0.93) in patients treated with avatrombopag was not significantly different from that in patients treated with placebo. The incidence of adverse events in patients treated with avatrombopag was slightly higher than that in patients treated with placebo (RR: 1.25, 95% CI [1.05 to 1.49], p = 0. 01) after one trial with high heterogeneity was removed. Conclusions: This meta-analysis showed that avatrombopag was an effective treatment for thrombocytopenia, but there is sufficient evidence to indicate that adverse events may occur.

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Thrombocytopenia

Cited by 7 publications

References 59 publications

Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients

Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients

The Usefulness of Platelet Distribution Width and Platelet Distribution Width to Lymphocyte Ratio in Predicting Severity and Outcomes in Patients with Snakebite

Efficacy and Safety of Avatrombopag in Patients With Thrombocytopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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