Volumen plaquetario medio como predictor de la mortalidad en pacientes con sepsis: revisión sistemática y metanálisis

Páez, Jorge Luis Vélez; Velarde-Montero, Carlos; Irigoyen-Mogro, Estefanía; Páez, Pablo Andrés Vélez; Cifuentes-López, Paulina; Vélez, Jorge; Albitres-Flores, Leonardo; Barboza, Joshuan J.

doi:10.22354/in.v24i3.861

Cited by 3 publications

(3 citation statements)

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“…Studies report that at high altitudes, hypoxia in non-acclimatized people generates hyperreactivity and greater platelet aggregation in response to adenosine diphosphate (ADP) and could increase MPV [ 24 ]. Evidence report MPV greater than 8.7 to predict adverse outcomes [ 18 , 25 , 26 ]. In our study, the MPV values exceeded this estimate throughout the follow-up.…”

Section: Limitationsmentioning

confidence: 99%

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

Páez

Légua

Páez³

et al. 2022

PLoS ONE

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Introduction 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. Objective 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. Methods 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. Results 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. Conclusions 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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Section: Limitationsmentioning

confidence: 99%

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

Páez

Légua

Páez³

et al. 2022

PLoS ONE

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“…Simultaneously, we observed statistical significance in the ROC curve with relevant AUC for lactate at admission with a cut-off point of ≥1.15 mmol / L, which significantly marked septic states' progression. Although no bibliography contrasts these results in patients without sepsis, in patients with sepsis, some studies, for example, two large meta-analyses 25,26 show that the MPV increases at 72 hours, with cut-off points that differ in these studies and is associated with septic states and even higher mortality. When the host's inflammatory response has not been controlled, it has a strong impact, inducing greater clinical severity and unfavorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

The behavior of Mean Platelet Volume in Sepsis in critical patients with and without sepsis

Páez¹,

Páez

2021

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The mean platelet volume is an anatomical biomarker that has shown its usefulness in various cardiovascular and metabolic pathologies; in sepsis, it has been positioning itself as an indicator of mortality, easily accessible and immediately applicable when reported in the routine blood count. This study demonstrates the mean platelet volume's biological behavior in critical patients with sepsis compared with non-septic patients. An observational, longitudinal, prospective, monocentric cohort study was conducted in 250 patients treated at the intensive care unit of the Pablo Arturo Suárez Hospital, Quito- Ecuador, from January 2019 January 2020. A group of patients with sepsis (n = 125) and without infectious pathologies (n = 125) were studied. The inclusion criteria were patients over 18 years of age of both genders, diagnosed with sepsis or septic shock using SEPSIS 3 criteria, and patients without septic pathology. The mean platelet volume (MPV) of days 1, 2, and 3 were studied. Septic patients had a mean APACHE (18.74 SD 9.52) higher than the non-septic ones (11.93 SD 7.01) (p = < 0.000). The MPV was consistently higher in patients with sepsis than non-septic patients, but it reached statistical significance on day 3 (9.13 SD 1.55 vs. 8.66 SD 1.34, p=0.042). The MPV on day 3 presented a significant area under the curve (AUC =0.580) (CI. 0.500-0.661), where the cut-off point according to Youden's index was positive for sepsis if MPV≥ 9.85 femtoliter (fL) with OR=3.30 and p-value= 0.005. Likewise, lactate on admission showed an AUC of 0.625 (CI. 0.555-0.694), with a cut-off point ≥of 1.15 mmol / L, OR=2.51, and p=0.007. Age and hypertension did not show a multivariate relationship with the presence of sepsis. It was shown that MPV is higher in patients with sepsis compared to non-septic ones. This observation reaches significance on day 3. Additionally, elevated lactate at admission was also associated with a septic state. On the other hand, platelet count did not show the expected behavior.

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“…Dicho lo anterior, en el año 2018 se puede mencionar que la sepsis afectó entre 27 y 30 millones de personas de las cuales entre siete y nueve millones murieron, por otro lado, las que sobrevivieron manifiestan secuelas de la misma. (3) Los hemocultivos permiten la detección de bacteriemia permitiendo el diagnóstico y pronóstico para la toma de decisiones clínicas. Además, la medición de biomarcadores como la procalcitonina (PCT), proteína C Reactiva (PCR) y lactato deshidrogenasa (LDH) apoyan también al diagnóstico y pronóstico de sepsis.…”

Section: Introductionunclassified

Mean platelet volume and its close relationship with septic hospital infections

Freire

Paredes

2023

Salud, Ciencia y Tecnología

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Introduction: the average platelet volume is obtained from the blood count, considered as a low-cost and easily accessible biomarker, available in all medical units. It is considered a biomarker that indicates inflammation, thrombosis, and endothelial injury, while foreign studies have shown encouraging advances in diseases with prothrombotic and immunoinflammatory components. Objective: to establish the relationship of mean platelet volume with hospital septic infections. Methodology: information sources available in the Pubmed, Medicgraphic, and SciELO databases were consulted, as well as the Google Scholar search engine. Publications in both English and Spanish were included, with a maximum of 5 years prior to the topic of interest. Results: original articles were analyzed in which populations of neonates and adults with sepsis are analyzed. Populations of newborns reflected a high value of MPV in the first 24 hours, proving to be an early predictive marker in the diagnosis of neonatal sepsis, while population studies in adults reflected a much higher MPV in septic patients who later died. in relation to those who survived, being also considered a predictor of mortality. Conclusions: it is evident that MPV is closely related to sepsis since it increases progressively during infection, constituting a biomarker for early prediction and poor prognosis in sepsis.

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Volumen plaquetario medio como predictor de la mortalidad en pacientes con sepsis: revisión sistemática y metanálisis

Cited by 3 publications

References 21 publications

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

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

The behavior of Mean Platelet Volume in Sepsis in critical patients with and without sepsis

Mean platelet volume and its close relationship with septic hospital infections

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