Platelet Distribution Width In Patients Research Articles

Prognostic value of combined preoperative inflammatory marker neutrophil-lymphocyte ratio and platelet distribution width in patients with gallbladder carcinoma.

The neutrophil-lymphocyte ratio (NLR) and platelet distribution width (PDW) are associated with poor prognosis in various cancers. We aimed to analyze the prognostic value of the combination of preoperative NLR and PDW in patients with gallbladder carcinoma (GBC). A total of 287 GBC patients who underwent curative-intent surgery in our institution was included. The relationship between NLR and PDW and clinicopathological features were analyzed. The receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value for NLR and PDW. Overall survival (OS) was estimated using the Kaplan-Meier method. Meanwhile, the univariate and multivariate Cox regression models were used to assess the risk factors for OS. The optimal cutoff value of NLR and PDW was 3.00 and 14.76, respectively. In addition, survival analysis demonstrated that patients with NLR > 3.00 and PDW > 14.76 had a worse prognosis than patients with NLR ≤ 3.00 and PDW ≤ 14.76, respectively. The multivariate analysis showed that NLR and PDW were independent prognostic factors in the patients with GBC. When we combined NLR and PDW, the area under the ROC curve increased from 0.665 (NLR) and 0.632 (PDW) to 0.676. Moreover, the 1-, 3-, and 5-year OS of group A (patients with NLR ≤ 3.00 and PDW ≤ 14.76), group B (patients with either of NLR > 3.00 or PDW > 14.76) and group C (patients with NLR > 3.00 and PDW > 14.76) were 88.7%, 62.6%, 28.1%, 65.1%, 26.9%, 13.1%, and 34.8%, 8.3%, 0%, respectively. The combination of NLR and PDW may serve as a significant prognostic biomarker for GBC patients superior to either NLR or PDW alone.

A Systematic Review and Meta-Analysis of Mean Platelet Volume and Platelet Distribution Width in Patients with Obstructive Sleep Apnoea Syndrome.

Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent yet underestimated disorder caused by the complete or partial obstruction of the upper airways. Although polysomnography is the gold standard for OSAS diagnosis, there is an active search for easily accessible biomarkers of disease presence and severity, particularly those reflecting morphological changes in specific blood cells. We investigated the associations between the presence and severity of OSAS, continuous positive airway pressure (CPAP) treatment, mean platelet volume (MPV), and platelet distribution width (PDW), routinely assessed as part of the complete blood count. From 262 retrieved records from PubMed, the Web of Science, Scopus, and Google Scholar, 31 manuscripts were selected for a final analysis, 30 investigating MPV and 15 investigating PDW. MPV was not statistically different between OSAS patients and healthy controls; however, it progressively increased with disease severity. By contrast, OSAS patients had significantly higher PDW values than controls (SMD = 0.40, 95% CI: 0.25 to 0.56; p ˂ 0.001), and the difference increased with disease severity. In a univariate meta-regression, there were significant associations between the MPV and publication year, the apnoea-hypopnea index, and diabetes mellitus, while no associations were observed with the PDW. No significant between-group differences were observed in the subgroup analyses. These data suggest that PDW, and to a lesser extent, MPV, are potential biomarkers of OSAS and require further research to ascertain their pathophysiological significance (PROSPERO, CRD42023459413).

Do Mean Platelet Volume and Platelet Distribution Width Have An Association with White Matter Hyperintensities in Migraine Patients?

Abstract Objective: Increased prevalence of white matter hyperintensities (WMH) is reported in migraine patients; however, the pathophysiology and the progression of these lesions are not definitely clear. Mean platelet volume (MPV) and platelet distribution width (PDW) are easily obtained markers for platelet activity. The aim of this study is to evaluate the relationship between the presence of WMH and MPV and PDW in patients with migraine in order to determine the role of platelet activity in the pathophysiology of WMH. Methods: Patients who were admitted to the neurology outpatient clinics of Baskent University Hospital from January 2011 to December 2015 with migraine and between 18 and 55 years of age were evaluated retrospectively. The blood samples were taken and total blood count parameters including MPV and PDW were analyzed. Brain magnetic resonance images were evaluated. Results: Totally, 218 patients were evaluated in this study. Forty-eight (22.0%) patients had WMH in the brain magnetic resonance imaging. In patients with WMH, the median of age was higher than the patients without WMH and the difference was statistically significant (P < 0.05). There was no statistically significant difference between MPV, PDW values, and the presence of WMH. Conclusions: There are multiple theories suggested for the mechanism of WMH, but the major cause and pathophysiology are still undetermined. Our data suggested that increased platelet activity is insufficient by itself to explain the pathophysiology of WMH in migraine patients and to improve the knowledge on this issue further large longitudinal studies should be performed.

New Hematological Parameters as Inflammatory Biomarkers: Systemic Immune Inflammation Index, Platerethritis, and Platelet Distribution Width in Patients with Adult Attention Deficit Hyperactivity Disorder.

ObjectivesThe potential role of neuroinflammation in adult attention deficit hyperactivity disorder (ADHD) patients has been investigated with peripheral hemogram-related inflammatory markers. Systemic immune inflammation index (SII) is defined as a new index that has been developed for the balance of inflammatory and immune status.MethodsOur study was based on a prospective routine complete blood count(CBC) analysis of 74 Adult ADHD patients and 70 healthy participants. The DSM-5-Clinician version and Barratt impulsivity scale-11 were used to evaluate the participants.ResultsThere was no statistical difference in the comparison of the SII ratios, platelet distribution width (PDW), and plateretritis (PCT) (p>0.05 for each) in a group of a young adults with ADHD and in a comparison control group. These inflammatory indicators were found to be similar between patients newly diagnosed with ADHD (n=40) and patients using methylphenidate (n=34) (p>0.05 for each). The relationship between ADHD clinical symptoms and severity and inflammation was evaluated. A significant negative correlation was observed between attention deficit scores and PCT (r=−0.301, p=0.009). A positive significant correlation was found between hyperactivity scores and SII (r=0.247, p=0.034). A significant positive correlation was found between Barrat motor scores and PDW(r=241, p=0.038). In the regression analysis, the PCT variable changed the attention deficit variable (β=.33, t(70)= −2.703, p=.009, pr2= .094) predicted negatively and significantly.ConclusionsWe demonstrated the association of SII, which is independently associated with adverse outcomes in many diseases, and the severity of hyperactivity symptoms in adult ADHD. The fact that PCT predicts attention deficit negatively and decisively shows the importance of inflammatory assessments specific to clinical presentations. The critical importance of platelets in inflammatory processes in ADHD has been demonstrated once again with inflammatory markers such as SII, PLT, and PDW, which can be accessed by an easily applicable complete blood count method.

Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BackgroundPlatelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC).MethodsWe enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries.ResultsAccording to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P < 0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P < 0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator.ConclusionsThe prognosis of GC patients can be precisely predictable by using both PDW and RDW.

Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit.

Introduction The red blood cell distribution width (RDW) is a measurement of variations in the size of red blood cells. As the width increases, the rate of mortality also increases, although the reason for it is still not known. On the other hand, platelet distribution width (PDW) is also useful in predicting morbidity and mortality in sepsis and other critically ill patients. In our study, we planned to study the impact of both RDW and PDW and evaluate their prognostic importance with outcome in patients admitted in medicine intensive care unit (MICU). Material and Method In these cross-sectional observational studies, 1,300 patients were included who were admitted in MICU. Critically ill patients were defined on the basis of qSOFA score greater than 2. PDW and RDW were obtained from Coulter report of complete blood count. Parameters included in Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were taken and APACHE IV score was calculated. Correlation of RDW and PDW with outcomes such as length of ICU stay, use of mechanical ventilator, and discharge/death was done. Result The mean RDW (%) for the entire study population was 15.17 ± 3.01. The RDW (%) was significantly on the higher side in patients who succumbed to the disease as compared with the patients who were discharged. The correlation between the length of ICU stay (days) and RDW (%) was moderately positive and was significant (rho = 0.37, p ≤ 0.001). The correlation between the length of ICU stay (days) and PDW (%) was moderately positive and was significant (rho = 0.5, p ≤ 0.001). Conclusion RDW and PDW were found as significant indicators for period of stay in ICU, requirement for mechanical ventilation, and mortality rate in patients admitted to ICUs. As these are simple, easy to conduct, universally available tests, they can be regularly incorporated in patients admitted in ICUs.

The diagnostic value of platelet distribution width in patients with mild COVID-19.

COVID‐19 has a worldwide distribution; however, there is no effective diagnosis marker, especially for the mild‐type COVID‐19. The purpose of the current study was to identify parameters for mild‐type COVID‐19. We retrospectively analyzed a single‐center data of patients with mild COVID‐19. Forty patients diagnosed with COVID‐19 were enrolled. Peripheral blood indices between the admission and discharge times were collected and analyzed. The platelet distribution width (PDW) was shown to be an indicator of significant change. The receiver operating characteristic curve for PDW was 0.7; the sensitivity and specificity for PDW were 82.5% and 55.0%, respectively. Therefore, a potential diagnostic value of PDW for mild‐type COVID‐19 was demonstrated.

Evaluation of Platelet Parameters in Patients With Coronary Artery Disease

Coronary artery disease (CAD) is one of the leading causes of death worldwide; therefore, identifying new risk factors to predict the severity of the disease is thought to be associated with mortality reduction. In an effort to investigate whether platelet parameters are related to the extent of CAD and can be considered as risk factors, we designed experiments to evaluate platelet parameters in these patients. In a cross‐sectional study, sixty-nine patients with CAD (including fifty-two patients with acute coronary syndrome and seventeen patients with stable angina) and sixty-four healthy volunteers were evaluated for platelet count, mean platelet volume (MPV), and platelet distribution width (PDW). Echocardiography, electrocardiogram (ECG), and coronary angiography were conducted as well. Results showed significantly higher values for MPV and PDW in patients with acute coronary syndrome as compared to patients with stable angina and healthy volunteers (P&lt;0.001 and P=0.009, respectively). There was no significant difference in platelet count between patients and healthy volunteers (P=0.379). Our results also revealed a significant difference in the ejection fraction (EF) percentage between the three groups (P=0.008). Investigating the correlation between platelet parameters and EF percentage, ECG changes, and the results of coronary angiography did not show any significant association. The present study showed that the elevated levels of MPV and PDW in patients with CAD are not related to the extent of coronary artery disease, which was estimated by echocardiography, ECG changes, and coronary angiography. Thus, these parameters cannot be considered as risk factors for coronary artery disease.

Evaluation of Plateletcrit and Platelet Distribution Width in Patients with Non-Alcoholic Fatty Liver Disease: A Retrospective Chart Review Study.

BackgroundPlatelets are considered to be essential in proinflammatory environments, including atherosclerosis. The degree of platelet activation has been demonstrated to be correlated with plateletcrit and platelet distribution width. The main purpose of this study was to assess the relationship between plateletcrit (PCT), platelet distribution, and the degree of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD).Material/MethodsWe enrolled 225 biopsy-proven NAFLD patients and 142 control subjects without NAFLD. NAFLD patients were separated into 2 groups according to percentage of steatosis. Demographic and clinical data were collected retrospectively.ResultsPCT level was significantly higher in NAFLD group I and group II than in the control group. PCT was higher in the NAFLD groups than in the control group. However, there was no difference according to PCT and PDW levels between NAFLD groups.ConclusionsIn this study, a relationship was found between PCT and hepatosteatosis, but no relationship was found with PDW. PCT might be a useful biomarker for early detection of steatohepatitis in patients with nan-alcoholic fatty liver disease.

Platelet DistributionWidth (PDW): A novel platelet marker in thrombocytosis: An insight

Introduction: Automated haematology analysers measure several haematological parameters including platelet indices importantly PDW, MPV and Plateletcrit. PDW has been receiving attention among all platelet indices due to its usefulness for distinguishing between reactive thrombocytosis and clonal thrombocytosis. Objectives: 1.To compare the PDW values in Normal Individuals and in patients with thrombocytosis. 2.To analyse the utility of PDW in patients with Thrombocytosis. Materials and Methods: T his prospective observational study was conducted in central laboratory of Dr B R Ambedkar Medical college Hospital, a tertiary care hospital. PDW values which were obtained by automated haematoanalyser HORIBA were tabulated and compared in 250 individuals with normal platelet count and 250 cases of thrombocytosis. Detail analysis of PDW values were interpreted in thrombocytosis cases to study its utility. Results: An increase in mean PDW was observed in patients with thrombocytosis when compared with individuals with normal platelet count. Mean PDWshowed variations in patients with thrombocytosis with varied underlying aetiologies. Conclusion: PDW is a simple platelet index which increases during platelet activation. PDW is more specific marker of platelet activation since it does not increase during simple platelet swelling. Keywords: PDW, Thrombocytosis, Variations, Reactive thrombocytosis.

Comparison of erythrocyte distribution width, mean platelet volume and platelet distribution width in patients with obstructive sleep apnea syndrome

Amac: Obstruktif uyku apne sendromunda (OUAS) intermitant hipoksiye bagli gelisen kronik inflamasyonun PAP tedavisine yanitini degerlendirmede kullanilacak guvenilir belirteclere ihtiyac vardir. Bu calismada, pozitif havayolu basinci tedavisinin uzun donem sonuclarinin hemogram parametreleri uzerine etkisini ve OUAS'li hastalarda inflamasyon ve hastaligin ciddiyeti ile iliskisini arastirmayi amacladik. Yontemler: Calisma prospektif kohort tipi calisma olarak planlandi. Polisomnografi (PSG) sonuclarina gore OUAS saptanmayan 61 katilimci (%35.1) kontrol grubu olarak alindi. OUAS saptanan 113 hasta (%64,9) calisma grubu olarak alindi. Calisma grubunun (%31,6)’si orta OUAS, 58'i (%33,3) siddetli OUAS idi. Hastalarin MPV, PDW, RDW, hemoglobin, hemotokrit, trombosit degerleri degerlendirildi ve alti ve on iki ay arayla karsilastirildi. Bulgular: Yaslari 33 ile 62 arasinda degisen, toplam 174 hasta calismaya alindi. Baslangicta hemoglobin, hematokrit ve MPV degerleri calisma grubunda kontrol grubuna gore anlamli derecede yuksek (sirasiyla P=0,008, P=0,007, P=0,004), her iki grupta da 6 ve 12 aydaki dususler istatistiksel olarak anlamliydi (sirasiyla P=0,004, P=0,003, P=0,004). Sonuc: Tum katilimcilarin erkek olmasi hemogram parametrelerine hormonal etkilerin dislanmasi nedeni ile idi. Ancak calismaya sadece erkek katilimcilarin dahil edilmesi ayni zamanda bu calismanin limitasyonu olabilir. Calismamiz MPV, RDW, PDW ve hemoglobin, hematokrit degerleri ve OUAS siddeti arasinda bir iliski oldugunu gostermistir. MPV, RDW, hemoglobin, hematokrit, trombosit, PAP tedavisini degerlendirmeyi bekleyen OUAS hastalarini onceliklendirmede faydali kilan basit, ucuz bir kan biyobelirtecine donusebilir.

Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty

Aim: Increased platelet activity and elevated mean platelet volume (MPV) has been demonstrated in patients with rheumatic mitral stenosis (RMS). However, platelet distribution width (PDW) and the impact of percutaneous mitral balloon valvuloplasty (PMBV) on PDW has never been studied. Therefore, we aimed to investigate whether PMBV decreases PDW in patients with RMS.Material and Methods: Symptomatic patients with severe RMS undergoing PMBV were included. Echocardiographic characteristics and hematologic parameters was measured just before and 1 month after the PMBV procedure.Results: A total of 30 patients (24 female, mean age: 49.8±13.2 years) were included the study. Mean transmitral pressure gradient, pulmonary artery pressures and left atrium diameter decreased but mitral valve area increased significantly after PMBV. PMBV procedure significantly decreased PDW in patients with RMS (13.5±2.3 vs 12.4±1.9 fL, before and after procedure, respectively; p&amp;lt;0.0001). MPV was decreased after PMBV but it was not statistically significant (10.9±0.8 vs 10.6±0.9 fL, p=0.056). Platelet count was significantly increased after procedure (250±62.6 vs 273.5±78.6 x103/ul, p=0.035). In linear regression analysis, an independent relationship was found in magnitude of PDW decrease and magnitude of increase in mitral valve area (ẞ:0.491, p=0.046). Conclusion: PMBV is associated with a significant decrease in PDW 1 month after the procedure. There was a significant correlation between the magnitude of decrease in PDW and magnitude of increase in mitral valve area after PMBV.

Influences of platelet distribution width on the prognosis of patients with nasopharyngeal cancer

Objective To investigate the influences of platelet distribution width (PDW) on the prognosis of nasopharyngeal cancer patients. Methods A total of 186 patients with nasopharyngeal cancer from January 2009 to December 2013 in our hospital were selected. The patients were aged from 48 to 79 years old, with an average age (61.8±8.2) years old. The age, gender, lung function, liver function, body mass index(BMI), smoking, drinking, histological type and staging of patients were recorded. The patients were followed up after discharge, and the mean follow up period was 28 months (12-36 months). The terminal event was nasopharyngeal cancer related death or the end of follow up. The best threshold of receiver operating characteristic (ROC) curve for the overall survival rate of PDW was tested, and the patients were divided into ≥ best thres-hold group and < best threshold group. The prognostic factors were analyzed by single factor analysis and Cox multiple regression analysis. Results The best threshold of ROC curve for the overall survival rate of PDW was 16.4%. The patients were divided into PDW≥16.4% group and PDW<16.4% group. There were no statistically significant differences in age (t=0.712, P=0.478), gender (χ2=0.044, P=0.834), BMI (t=0.593, P=0.554), smoking (χ2=0.063, P=0.802), drinking (χ2=0.555, P=0.456), forced expira-tory volume in one second/forced vital capacity (FEV1/FVC, t=1.711, P=0.089), alanine transaminase (ALT, t=1.756, P=0.081), histological type (χ2=0.259, P=0.879) and staging (Z=2.443, P=0.486) between the two groups. Results of single factor analysis showed that there were statistically significant differences in age (χ2=4.611, P=0.032), gender (χ2=3.952, P=0.047), smoking (χ2=5.564, P=0.018), FEV1/FVC (χ2=4.321, P=0.038), staging (χ2=6.021, P=0.014) and PDW (χ2=4.511, P=0.034) between the two groups. Cox risk model of multifactor analysis showed that the elderly (≥60 years, χ2=5.429, P=0.020), male patients (χ2=4.648, P=0.031), smoking (χ2=18.453, P<0.001), Ⅲ-Ⅳ staging (χ2=9.612, P=0.002) and PDW≥16.4% (χ2=6.008, P=0.014) were independent prognostic factors in patients with nasopharyngeal cancer. Conclusion The degree of PDW in patients with nasopharyngeal cancer affects the prognosis of patients, and the patients with PDW≥16.4% have the better prognosis. Key words: Nsopharyngeal neoplasms; Survival rate; Platelet distribution width

Platelet Profile in Patients with Status Asmaticus in Kebumen

BACKGROUND: Asthma has been considered as type 1 hypersensitivity disease, but actually asthma involves a variety of inf lammatory factors.Based on pro-inf lammatory cells, asthma is classified into eosinophilic, non-eosinophilic, neutrophilic, and non-neutrophilic. Platelet plays a role in pathophysiology of asthma through inf lammation. However, platelet profile in patients with asthma have not been established.OBJECTIVE: to determine the platelet indices of patients with status asmaticus of different phenotypes.METHODS: a cross-sectional study was conducted among a minimum sample size of 67 patients. Data were collected from medical records of patients in RSUD Kebumen. Platelet indices included mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT).RESULTS: There was no significant difference in the value of MPV and PDW in patients with eosinophilic and neutrophilic asthma (p&gt; 0.05). But,there was a significant difference in PCT between the two groups (P &lt;0.05)CONCLUSION: There was difference only in plateletcrit (PCT) between patients with eosinophilic and netrophilic asthma.

Variación del volumen plaquetario medio y el ancho de distribución de plaquetas como marcador clínico temprano de preeclampsia

Objetivo: evaluar la variación del volumen plaquetario medio (VPM) y el ancho de distribución de plaquetas (ADP) como un marcador clínico relacionado con el desarrollo de la preeclampsia.Materiales y métodos: estudio correlacional, ensamblado en una cohorte prospectiva en una población de mujeres con gestación de feto único de entre 14 y 40 años, sin antecedentes o presencia de patologías sistémicas vasculares, que asistieron al menos a dos controles prenatales en las semanas 13 y 33 de gestación, y que ingresaron posteriormente por complicaciones de fin de embarazo, o para atención de parto en un hospital de referencia ubicado en Guayaquil, Ecuador. Muestreo no probabilístico por conveniencia. Variables medidas: sociodemográficas, clínicas y valores de VPM y ADP en unidades de femtolitros (fL). Se compara la variación del VPM y el ADP entre las semanas 13 y 33 en el grupo de gestantes con y sin preeclampsia por medio de la prueba de rangos con signo de Wilcoxon para muestras relacionadas, y se evalúa la exactitud de estas pruebas para el diagnóstico de preeclampsia.Resultados: se evaluaron 84 gestantes. Se encontró una variación promedio de 0,9 fL (DE ± 0,3) para el volumen plaquetario medio, y de 1,7 fL (DE ± 0,28) del ancho de distribución de plaquetas en las pacientes que desarrollaron preeclamsia. Las mejores características diagnósticas se encontraron al tomar el valor mínimo de variación de la media de 0,6 fL y 1,4 fL para VPM y ADP respectivamente, con un área bajo la curva de 0,75, un odds ratio diagnóstico (ORD) de 12,4, una sensibilidad de 61 % y una especificidad de 88,7 % para el diagnóstico de preeclampsia.Conclusiones: la evaluación de la variación de VPM y ADP entre el primer y tercer trimestre de gestación podría ser un método útil para el diagnóstico de la preeclampsia, independientemente del valor medido en cada etapa.

Evaluation of mean platelet volume and platelet distribution width in patients with asymptomatic intermediate carotid artery plaque.

Platelets play a significant role in the pathogenesis of atherosclerosis. In atherosclerotic plaques, the risk of plaque rupture is more crucial than the severity of the stenosis they cause. Non-calcified carotid artery plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis, with respect to mean platelet volume (MPV) and platelet distribution width (PDW). A total of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n = 73) and non-calcified (n = 66) plaque groups were compared with respect to MPV and PDW. Mean platelet volume was statistically significantly higher in the non-calcified plaque group compared to the cal-cified plaque group (MPV in non-calcified/calcified plaque groups [fL]: 10.0/9.0, respectively) (p < 0.01). PDW was not significantly different between the two groups (p = 0.09). Platelet count was statistically significantly higher in the calcified plaque group compared to the non-calcified plaque group (platelet count in calcified/non-calcified plaque groups [10³/mm³]: 250 ± 63/226 ± 56, respectively) (p = 0.019). Multivariate regression analysis showed that MPV was independently associ-ated with non-calcified carotid artery plaque (odds ratio 5.95, 95% confidence interval 2.63-13.45, p < 0.001). Mean platelet volume is increased in the presence of non-calcified carotid artery plaques that cause asymp-tomatic intermediate stenosis. Increased MPV can be used as a marker to predict the risk of rupture of the non-calcified carotid artery plaques.

Prognostic impact of platelet distribution width in patients with Crimean-Congo hemorrhagic fever.

Platelet distribution width (PDW) is a readily available blood test involving calculations performed by automated blood analyzers. Crimean-Congo hemorrhagic fever (CCHF) may exhibit a severe profile with fatal hemorrhaging or else present with a mild clinical process. The purpose of our study was to investigate the importance of PDW in CCHF patients and its clinical prognostic value. This study was conducted with patients with CCHF. Patients were divided into two groups on the basis of presence or absence of bleeding. Demographic characteristics, clinical findings, PDW, and other laboratory tests were recorded onto forms. A total of 423 patients were included. Hemorrhaging was observed in 27.9% during hospitalization. PDW on the first day of hospitalization was 17.2 ± 0.9% in the hemorrhagic patients and 17.1 ± 0.6% in the cases without hemorrhage (P = 0.290). On the third day of hospitalization, PDW was 17.6 ± 0.8% in the hemorrhagic patients and 17.0 ± 0.7% in the cases without hemorrhage (P < 0.001). At a third-day PDW level cut-off point of 17.1%, AUROC was 0.677, sensitivity 65.5%, specificity 54.6%, PPV 35.5%, and NPV 80.6%. A one-unit raise in third day PDW stepped up the probability of bleeding in patients with CCHF 3.45-fold at logistic regression analysis. This study shows that PDW is a parameter that may be used to determine disease severity. This parameter may be at least as useful as platelet count in helping clinicians identify severe cases. Early identification of cases with a severe course will make it possible to provide early planning of modalities such as intensive care support. J. Med. Virol. 88:1862-1866, 2016. © 2016 Wiley Periodicals, Inc.

Mean Platelet Volume and Platelet Distribution Width as Markers in the Diagnosis of Acute Gangrenous Appendicitis.

Introduction. Acute gangrenous appendicitis (AGA) is a common medical condition; however, the grade of appendicitis usually cannot be established preoperatively. We have attempted to identify some indicators, such as the mean platelet volume (MPV) and the platelet distribution width (PDW), to diagnose AGA. Aims. To evaluate whether or not the MPV and PDW are suitable markers to diagnose AGA. Methods. A retrospective study of 160 patients with AGA and 160 healthy patients was undertaken. Disease diagnosis was confirmed based on the pathologic examination of surgical specimens. Patient white blood cell (WBC) count, neutrophil ratio (NR), platelet (PLT) count, MPV, PDW, and hematocrit (HCT) were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of these indices in AGA. Results. There were no significant differences between the AGA and control groups in age and gender. Compared to the control group, the WBC count, NR, and PDW were significantly higher (P < 0.001, resp.) and the MPV and HCT were significantly lower (P < 0.001, resp.) in the AGA group. The diagnostic specificities of the WBC count, NR, PLT count, MPV, PDW, and HCT were 86.3%, 92.5%, 58.1%, 81.7%, 83.9%, and 66.3%, respectively. Therefore, the NR had the highest diagnostic specificity for the diagnosis of AGA. Conclusions. This is the first study to assess the MPV and PDW in patients with AGA. Our present study showed that the MPV is reduced and the PDW is increased in patients with AGA; the sensitivity of PDW was superior to the MPV. A decreased MPV value and an increased PDW could serve as two markers to diagnose AGA. The NR had the highest specificity for the diagnosis of AGA.

Platelet profile is associated with clinical complications in patients with vivax and falciparum malaria in Colombia.

Thrombocytopenia is a common complication in malaria patients. The relationship between abnormal platelet profile and clinical status in malaria patients is unclear. In low and unstable endemic regions where vivax malaria predominates, the hematologic profiles of malaria patients and their clinical utility are poorly understood. The aim of this study was to characterize the thrombograms of malaria patients from Colombia, where Plasmodium vivax infection is common, and to explore the relationship between thrombograms and clinical status. Eight hundred sixty-two malaria patients were enrolled, including 533 (61.8%) patients infected with Plasmodium falciparum, 311 (36.1%) patients infected with Plasmodium vivax and 18 (2.1%) patients with mixed infections. The most frequently observed changes were low platelet count (PC) and high platelet distribution width (PDW), which were observed in 65% of patients; thrombocytopenia with <50,000 platelets/µL was identified in 11% of patients. Patients with complications had lower PC and plateletcrit (PT) and higher PDW values. A higher risk of thrombocytopenia was identified in patients with severe anemia, neurologic complications, pulmonary complications, liver dysfunction, renal impairment and severe hypoglycemia. The presence of thrombocytopenia (<150,000 platelets/µL) was associated with a higher probability of liver dysfunction. Young age, longer duration of illness and higher parasitemia are associated with severe thrombocytopenia. Our study showed that thrombocytopenia is related to malaria complications, especially liver dysfunction. High PDW in patients with severe malaria may explain the mechanisms of thrombocytopenia that is common in this group of patients.

Could platelet distribution width be a predictive marker for unexplained recurrent miscarriage?

The aim of our study was to evaluate the platelet function in unexplained recurrent miscarriage and to investigate whether any hematologic changes detectable by simple complete blood count have a diagnostic value for the prediction of unexplained recurrent miscarriage. A prospective study based on the comparison of 74 patients with unexplained recurrent first-trimester pregnancy loss with 208 control subjects matched for age. The two groups were compared in terms of platelet indices. There was a significant difference in platelet distribution width in patients with unexplained recurrent miscarriage compared to healthy control subjects. Platelet distribution width values in the patient group were statistically higher (P < 0.001) than the control group. Our study provides an evidence that platelet distribution width gradually increases in women with recurrent miscarriage compared to control group. Patients with unexplained recurrent miscarriage have significantly increased platelet aggregation. This data may provide an empirical rationale for the use of anticoagulants in the management of this clinical condition.