Utility of Platelet Indices as Prognostic Markers of Sepsis: A Medical Intensive Care Unit-Based Cross-Sectional Study at a Rural Setup.

Abstract

Introduction Even after the breakthrough advancements in the management and prognostic scoring of sepsis, it remains an important cause of morbidity and mortality encountered in intensive care units (ICUs) throughout the globe. This study highlights the utility of platelet indices as prognostic markers of sepsis. Methods In the present prospective cross-sectional study, a total of 177 patients with sepsis were enrolled using the Sepsis-3 criteria. The platelet indices were then linked to severity using the Acute Physiology and Chronic Health Evaluation (APACHE) II score. The correlation of platelet indices to morbidity in terms of the length of ICU stay, need for a mechanical ventilator, types of infection, and mortality was also assessed. Results The results showed that mean platelet volume (p = 0.004) and platelet distribution width (PDW; p = 0.009) were positively correlated with the severity of sepsis. Among all the parameters, plateletcrit (%) was the best predictor of the need for an invasive mechanical ventilator at a cutoff point of ≤0.22 with a 60.90% chance of correctly predicting the need for an invasive mechanical ventilator, as was mortality at a cutoff point of ≤0.22 with a 67.30% chance of correct prediction. Among the platelet indices, only PDW showed a significant association with growth in culture because patients with growth had significantly higher PDW as compared to those who did not have growth (22.4 ± 4.47 vs 20.81 ± 4.29, p = 0.011). Conclusion The difference between the survivors and non-survivor groups was statistically significant for platelet indices, making them easily available, cost-effective, and useful prognostic markers for patients in septic shock. This will help in easy understanding and preventing its morbid complications, even at the primary care physician level.