Abstract
BackgroundMean platelet volume (MPV) is a reflection of platelet size, which has been shown to correlate with platelet function and activation. The aim of this study was to evaluate whether MPV could be used for the diagnostic tool of community-acquired pneumonia (CAP) and for making the decision for hospitalization.MethodsThe computerized records of children aged 1 to 18 years who were diagnosed with CAP based on WHO criteria were evaluated. A standard protocol was followed, and patients with severe CAP were hospitalized. CAP patients were divided into two groups based on disease severity. The control group consisted of age and gender matched healthy children during the study period. Values for hemoglobin, white blood cell count (WBC), platelet count, MPV and C-reactive protein (CRP) obtained on first presentation were recorded for each patient.ResultsA total of 196 patients were diagnosed with CAP during the study period, 108 (55.1%) of which had severe disease, which required hospitalization (Group 1a), while the remaining 88 (44.9%) were followed-up as outpatients (Group 1b). The control group consisted of 100 healthy children (Group 2). Patients with CAP had lower MPV values than their healthy counterparts (7.1±0.68 vs. 8.31±1.2 fL; p<0.001). MPV value was significantly higher in hospitalized CAP patients compared to outpatients (7.32±0.71 vs. 6.83±0.5 fL; p=0.012). ROC curve analysis suggested that MPV level cut-off point for making a diagnosis of CAP was 8.1 fL, with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 91%, 51%, 80.8% and 70.5%, respectively.ConclusionsOur findings suggest that MPV may be a useful predictor for diagnosed CAP but low specificity and NPV rates may lead to the false-negative diagnosis.
Highlights
Community-acquired pneumonia (CAP) is a serious and frequent cause of hospital admission in early childhood [1] In developing countries, the incidence of childhood hospitalizations due to community-acquired pneumonia (CAP) is estimated to be 8.7% of all cases of CAP [2], whereas the hospitalization rates for children under the age of 5 years in the UK and USA are 2.9/1000 [3] and 6.6/1000 [4], respectively
Patients with CAP had a significantly lower mean Mean platelet volume (MPV) value compared to healthy controls (7.1±0.68 vs. 8.31±1.2 fL; p
ROC curve analysis suggested that MPV level cut-off point for making a diagnosis of CAP was 8.1 fL, with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 91%, 51%, 80.8% and 70.5%, respectively (Area under curve: 0.796)
Summary
Community-acquired pneumonia (CAP) is a serious and frequent cause of hospital admission in early childhood [1] In developing countries, the incidence of childhood hospitalizations due to CAP is estimated to be 8.7% of all cases of CAP [2], whereas the hospitalization rates for children under the age of 5 years in the UK and USA are 2.9/1000 [3] and 6.6/1000 [4], respectively. There is a growing body of clinical evidence suggesting that platelets play an important role in the inflammatory response. Multiple inflammatory factors such as chemokines, cytokines and coagulation factors are secreted by platelets, which increase in size when they are activated. A higher MPV value is indicative of increased platelet activity and more intense inflammation [9]. The aim of our study was to investigate whether MPV values are affected by the inflammatory response in childhood CAP. The aim of this study was to evaluate whether MPV could be used for the diagnostic tool of community-acquired pneumonia (CAP) and for making the decision for hospitalization
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