Association of Immature Platelet Fraction and Trombopoietin Levels Based on the Grades of Sepsis Severity

Abstract

Sepsis is one of the major causes of morbidity and mortality around the world. Organ dysfunction in sepsis can be identified using Sepsis-related Organ Failure Assessment. The dysfunction of the coagulation cascade, the number of pro-inflammatory cytokines, and endothelial dysfunction promote the consumptive thrombocytopenia in sepsis patients, which triggers a compensatory response in the body by increasing thrombopoietin release. As a result, it increases platelet production which can be assessed by immature platelet fraction (IPF). This study is a preliminary research to see the relationship between IPF values and serum thrombopoietin (TPO) levels in terms of the clinical severity of patients with sepsis based on SOFA scores. A cross-sectional design was performed in this study with 49 samples of patients with sepsis, collected during June-July 2019, at Dr. Wahidin Sudirohusodo Hospital in Makassar. The study was conducted in August 2019. IPF values were measured by the fluorescent flow cytometry method. Meanwhile, serum thrombopoietin levels were calculated by the enzyme-linked immunosorbent assay (ELISA) method using human Thrombopoietin ELISA (RayBioTech, Australia). The results showed that the IPF value increased along with the SOFA score, followed by a decrease in platelet (p = 0.014). TPO levels presented an upward along with SOFA scores with a decrease in platelet (p = 0.008). There was a significant correlation between IPF values and TPO levels (r = 0.606, p <0.001) where the Immature Platelet Fraction score and thrombopoietin levels increased with SOFA scores. In addition, there was also a positive correlation between IPF values and TPO levels in sepsis patients.