Abstract
Background Although mean platelet volume (MPV) appears to be associated with poor outcome of pneumonia, the relationship between MPV and in-hospital mortality is unclear in severe pneumonia (SP) patients. Methods In this retrospective cohort study, 115 SP patients from June 1st, 2016, to September 29th, 2019, were included and divided into two groups. The primary outcome was in-hospital mortality. The receiver operating characteristic (ROC) curve was performed to assess the predictive ability for in-hospital mortality. Kaplan-Meier cumulative incidence curves were applied to observe the incidence of mortality. Multivariable Cox regression analyses were used to evaluate the hazard ratios (HRs). Besides, a formal test for interaction was investigated to analyze the relationship between MPV and sex. Results During the course of hospitalization, 63 cases of mortality were recorded. ROC analysis suggested that MPV had a modest power for predicting in-hospital mortality (AUC = 0.723, 95% CI: 0.628-0.818, P < 0.001). Yet the cutoff value of MPV was 10.5 (sensitivity = 73.02%; specificity = 73.08%). Compared to the low-MPV group, the high-MPV group had significantly increased in-hospital mortality (log-rank test = 13.501, P < 0.001), while the adjusted Cox model indicated that the high-MPV group was associated with an elevated risk of in-hospital mortality (HR: 2.267, 95% CI: 1.166-4.406, P = 0.016). Moreover, analyses of in-hospital mortality suggested a significant interaction between optimal MPV level and sex (P = 0.011). In a multivariate Cox model which included females only, a high MPV level was associated with increased risk of in-hospital mortality (HR: 11.387, 95% CI: 1.767-73.380, P = 0.011). Conclusion High MPV level is an independent risk factor for in-hospital mortality in patients with SP.
Highlights
Despite advances in its management over the last few decades, severe pneumonia (SP) remains a primary cause of death from infection across the globe, with a mortality rate ranging from 20% to more than 50% [1, 2]
Of 175 patients with SP admitted to the intensive care unit (ICU) from 1st June 2016 to 29th September 2019, 115 patients were eventually enrolled in the study (Figure 1)
We indicated that the mean platelet volume (MPV) at ICU admission is positively associated with in-hospital mortality in female patients with SP, after adjusting for potential confounders
Summary
Despite advances in its management over the last few decades, severe pneumonia (SP) remains a primary cause of death from infection across the globe, with a mortality rate ranging from 20% to more than 50% [1, 2]. Information indicating risk factors for the development of death in SP patients remains sparse. Mean platelet volume (MPV) appears to be associated with poor outcome of pneumonia, the relationship between MPV and in-hospital mortality is unclear in severe pneumonia (SP) patients. ROC analysis suggested that MPV had a modest power for predicting in-hospital mortality (AUC = 0:723, 95% CI: 0.628-0.818, P < 0:001). Analyses of in-hospital mortality suggested a significant interaction between optimal MPV level and sex (P = 0:011). In a multivariate Cox model which included females only, a high MPV level was associated with increased risk of in-hospital mortality (HR: 11.387, 95% CI: 1.767-73.380, P = 0:011). High MPV level is an independent risk factor for in-hospital mortality in patients with SP
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