Abstract
BackgroundClinical characteristics and the prognostic significance of changes in mean platelet volume (MPV) during hospitalization for community-acquired pneumonia (CAP) have not been investigated.MethodsAmong 976 adults hospitalized for CAP, clinical characteristics, in-hospital outcomes (transfer to the intensive care unit, treatment with mechanical ventilation, prolonged hospital stay and death), and all-cause mortality following discharge, were compared according to ΔMPV (MPV on discharge minus MPV on admission): groups A (no rising MPV, ΔMPV < 0.6 fL) and B (rising MPV, ΔMPV ≥ 0.6 fL).ResultsGroups A and B comprised 83.8% and 16.2% of patients, respectively. Patients with a rise in MPV were more likely to be older, and to present with renal dysfunction, cerebrovascular disorder and severe pneumonia than were patients with no rise in MPV. On discharge, lower values of platelets and higher levels of neutrophils were observed in group B. Rising MPV strongly predicted a need for mechanical ventilation and in-hospital death (the respective relative risks: 2.62 and 6.79; 95% confidence intervals: 1.54–4.45 and 3.48–13.20). The respective 90-day, 3-year and total (median follow-up of 54 months) mortality rates were significantly higher in group B (29.1%, 43.0% and 50.0%) than group A (7.3%, 24.2% and 32.6%), p < 0.001 for all comparisons. A rise in MPV was a powerful predictor of all-cause mortality (relative risk 1.26 and 95% confidence interval 1.11–1.43).ConclusionsRising MPV during hospitalization for CAP is associated with a more severe clinical profile than no rise in MPV. A rise in MPV strongly predicts in-hospital and long-term mortality.
Highlights
Clinical characteristics and the prognostic significance of changes in mean platelet volume (MPV) during hospitalization for community-acquired pneumonia (CAP) have not been investigated
The availability of complete blood count at admission and within 48 h of discharge or death, and with intervals between the determinations of at least 3 days, was a study inclusion criterion. Patients transferred from another hospital or from an intensive care unit (ICU), with possible health care-associated and nosocomial pneumonia, primary hematological disorders, advanced malignant disease or platelet transfusion were excluded from the analysis
Mean values of assigning point each for Confusion (CURB-65) and Pneumonia Severity Index (PSI) scores were significantly higher in group B
Summary
Clinical characteristics and the prognostic significance of changes in mean platelet volume (MPV) during hospitalization for community-acquired pneumonia (CAP) have not been investigated. A single measurement of elevated MPV has been reported to be associated with increased morbidity and mortality in Patients hospitalized with community-acquired pneumonia (CAP) are at an increased risk of death in the hospital and following discharge [16,17,18]. The prognostic significance of MPV has been reported in only two small studies on CAP patients, which were based on single. The clinical characteristics and prognosis of time-dependent MPV changes have not been investigated in the CAP population. We aimed to compare demographic, clinical, laboratory and radiographic characteristics, as well as short- and longterm outcomes of patients hospitalized for CAP, according to changes in MPV
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