The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review.

Yasemin Ustundag Budak,Murat Polat,Kagan Huysal

doi:10.11613/bm.2016.020

Yasemin Ustundag Budak, Murat Polat + Show 1 more

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https://doi.org/10.11613/bm.2016.020

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Abstract

Platelet indices (PI) — plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW) — are a group of derived platelet parameters obtained as a part of the automatic complete blood count. Emerging evidence suggests that PIs may have diagnostic and prognostic value in certain diseases. This study aimed to summarize the current scientific knowledge on the potential role of PIs as a diagnostic and prognostic marker in patients having emergency, non-traumatic abdominal surgery. In December 2015, we searched Medline/PubMed, Scopus and Google Scholar to identify all articles on PIs. Overall, considerable evidence suggests that PIs are altered with acute appendicitis. Although the role of PI in the differential diagnosis of acute abdomen remains uncertain, low MPV might be useful in acute appendicitis and acute mesenteric ischemia, with high MPV predicting poor prognosis in acute mesenteric ischemia. The current lack of consistency and technical standards in studies involving PIs should be regarded as a serious limitation to comparing these studies. Further large, multicentre prospective studies concurrently collecting data from different ethnicities and genders are needed before they can be used in routine clinical practice.

Highlights

Platelets are cytoplasmatic fragments of bone marrow megakaryocytes, with a diameter of 3-5 μm and a volume of 4.5–11 fL [1]
Platelet volume heterogeneity occurs during its production and increases mean platelet volume (MPV) and platelet distribution width (PDW) comparatively, suggesting that bone marrow produces platelets and rapidly releases them into circulation [18]
MPV can be a modifiable marker in identifying patients with active ankylosing spondylitis and rheumatoid arthritis, which is thought to be due to increased consumption of platelets in the inflammation area and MPV increases with therapy in these patients [37,44]

Summary

Introduction

Platelets are cytoplasmatic fragments of bone marrow megakaryocytes, with a diameter of 3-5 μm and a volume of 4.5–11 fL [1]. They allow extensive clinical investigations focusing on the diagnostic and prognostic values in a variety of settings without bringing extra costs Among these platelet indices, plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) are a group of platelet parameters determined together in automatic CBC profiles; they are related to platelets’ morphology and proliferation kinetics (Table 1). Platelet volume heterogeneity occurs during its production and increases MPV and PDW comparatively, suggesting that bone marrow produces platelets and rapidly releases them into circulation [18]. MPV can be a modifiable marker in identifying patients with active ankylosing spondylitis and rheumatoid arthritis, which is thought to be due to increased consumption of platelets in the inflammation area and MPV increases with therapy in these patients [37,44] Sepsis is another example of obvious interaction between the immune and haemostatic system.

Methods

Findings

Study design