Use Of Mean Platelet Volume Research Articles

Assessment of the Value of Mean Platelet Volume, Des Gamma Carboxy Prothrombin and Alpha Feto Protein in Early Detection of HCC

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. AFP is the gold standard tumor marker for HCC, mean platelet volume (MPV) is a parameter obtained from complete blood count (CBC) by automated analyzers, shown to be increased in multiple malignancies and inflammatory conditions. This cross sectional comparative study was designed to evaluate the diagnostic usefulness of MPV as a diagnostic marker in HCC patients due to cirrhosis. Aim of the Work To determine the value of mean platelet volume, Des gamma Carboxy prothrombin and Alfa-feto protein in early detection of Hepatocelluler carcinoma Patients and Methods 105 patients were enrolled in this study, they were divided into 3 equal groups Group A: Hepatocelluler carcinoma patients (HCC) Group B: Liver cirrhosis patients Group C: Healthy Control group each is 35 patients. MPV, AFP, DCP were evaluated in all groups. Ultrasound and Triphasic CT. were also done to Group A&B to confirm or exclude the diagnosis of HCC and in group C as they are candidates for LDLT donors. Results Our results showed that regarding the diagnostic performance of the three tested tumor markers (AFP, MPV and DCP) in differentiating HCC from CLD groups that AFP had area under curve (AUC) of 0.719, Standard error (SE) of 0.061, Confidence interval (CI) of 0.599-0.839 and P value of 0.002 at a cut point of ≥ 40.0, MPV had area under curve (AUC) of 0.801, Standard error (SE) of 0.063, Confidence interval (CI) of 0.678 − 0.924 and P value of < 0.001 at a cut point of ≥ 10.2, while DCP had area under curve (AUC) of 0.842, Standard error (SE) of 0.047, Confidence interval (CI) of 0.750 − 0.935 and P value of < 0.001 at a cut point of ≥ 69.3 proving that DCP had the highest significant diagnostic performance in differentiating HCC from CLD groups also DCP≥ 69.3 had highest sensitivity(of 97.1%) and NPV(of 96.3%). AFP≥ 40.0 had highest specificity (of 91.4%) and PPV (of 86.4%). Youden’s index was highest in DCP ≥69.3, followed by MPV ≥10.2 and lowest in AFP ≥40.0. MPV had moderate sensitivity and specificity in between AFP and DCP with values of 71.4% and 85.7% respectively with also moderate PPV of 83.3 and NPV of 75% Conclusion Measurement of MPV is non-invasive, cheap and quick, and may therefore serve as a predictor of HCC in patients with CLD. Low sensitivity and specificity, on the other hand, suggests that this may be an adjunctive parameter to some other markers like AFP. Further studies with larger samples are needed to determine the association of MPV with HCC. For a single test DCP had highest significant diagnostic performance in differentiating HCC from CLD groups. In detection of HCC testing AFP≥ 40.0 if positive considered positive. If negative, retest for DCP≥ 69.3 if positive considered positive, otherwise is negative. This although deceased specificity and Positive predictive value, it raised sensitivity and Negative Predictive Value to 100.0% when combining both AFP and DCP. The benefit of increasing the sensitivity is not to miss cases with HCC while the decreased specificity and PPV can be compensated by further imaging studies to eliminate the false positive cases.

Use of Mean Platelet Volume as a Predictor of Bleeding Risk in Thrombocytopenia

Use of Mean Platelet Volume as a Predictor of Bleeding Risk in Thrombocytopenia

Mean platelet volume: a prognostic marker in heart failure with preserved ejection fraction

Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with high burden of comorbidities known to increase the mean platelet volume (MPV). This parameter has been associated with morbidity and mortality in HF. However, the role of platelets and the prognostic relevance of MPV in HFpEF remain largely unexplored. We aimed to evaluate the clinical usefulness of MPV as a prognostic marker in HFpEF. We prospectively enrolled 228 patients with HFpEF (79 ± 9 years; 66% females) and 38 controls of similar age and gender (78 ± 5 years; 63% females). All subjects underwent two-dimensional echocardiography and MPV measurements. Patients were followed-up for a primary end point of all-cause mortality or first HF hospitalization. The prognostic impact of MPV was determined using Cox proportional hazard models. Mean MPV was significantly higher in HFpEF patients compared with controls (MPV: 10.7 ± 1.1fL vs. 10.1 ± 1.1fL, p = .005). HFpEF patients (n = 56) with MPV >75th percentile (11.3 fL) displayed more commonly a history of ischemic cardiomyopathy. Over a median follow-up of 26 months, 136 HFpEF patients reached the composite endpoint. MPV >75th percentile was a significant predictor of the primary endpoint (HR: 1.70 [1.08; 2.67], p = .023) adjusted for NYHA class, chronic obstructive pulmonary disease, loop diuretics, renal function, and hemoglobin. We demonstrated that MPV was significantly higher in HFpEF patients compared with controls of similar age and gender. Elevated MPV was a strong and independent predictor of poor outcome in HFpEF patients and may be relevant for clinical use.

The role of mean platelet volume (MPV) and platelet distribution width (PDW) pre-operating as sepsis indicators in laparotomy patients in Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia

Background: Sepsis has become the most common postoperative complication caused by major surgery. Early diagnosis of sepsis is very important to know the patient's prognosis and survival. Changes in mean platelet volume (MPV) and platelet distribution width (PDW) were assessed to have a relationship with the incidence of sepsis. The use of MPV and PDW platelet preoperative indicators is expected to help predict sepsis so that appropriate interventions can be given immediately. Methods: A total of 50 patients who met the inclusion criteria became the subjects of this study to determine the potential of MPV and PDW preoperative biomarkers for predicting sepsis in laparotomy patients. All blood tests for the diagnosis of sepsis were examined. Spearman's test and ROC curve were performed for statistical calculations to determine the cut-off point for MPV and PDW. Results: Analysis of the relationship between PDW and MPV values ​​as an indicator of sepsis using the Spearman test found a significant relationship between MPV and PDW ​​on the incidence of sepsis (p<0.05). Furthermore, statistical tests using the ROC area under the curve (AUC) curve, MPV levels were 0.968, which indicates that if MPV were examined in 100 patients, it would predict sepsis in 96 patients. Meanwhile, the AUC of PDW is 0.770, which shows that if MPV examination is performed in 100 patients, it will predict sepsis in 77 patients. . The best cut-off point ​​that the researchers got in this study was MPV levels 9.8 fL (sensitivity 93.3% and specificity 85%) and PDW levels 9.45 fL (70% sensitivity and 70% specificity). Conclusion: Preoperative MPV and PDW can be predictive indicators of sepsis in laparotomy surgery, with MPV sensitivity and specificity of 93.3% and 85% and sensitivity and specificity of PDW of 70% and 70%, respectively.

The Use of Mean Platelet Volume, Plateletcrit, and N-terminal Brain Natriuretic Peptide as Biomarkers of Coronary Artery Involvement in Atypical Kawasaki Disease

The Use of Mean Platelet Volume, Plateletcrit, and N-terminal Brain Natriuretic Peptide as Biomarkers of Coronary Artery Involvement in Atypical Kawasaki Disease

Mimicking platelet indices in patients with malaria and dengue hemorrhagic fever: characteristics and clinical applications

BackgroundAlthough platelet indices are routinely available using automated blood cell counters, the clinical applications of these parameters for malaria and dengue hemorrhagic fever (DHF) have not been substantially implemented. We conducted this study to investigate the potential role of platelet indices as a prognostic marker in adult patients with Plasmodium vivax malaria, Plasmodium falciparum malaria, and DHF admitted to the Hospital for Tropical Diseases, Bangkok, Thailand.MethodsWe enrolled 219 eligible patients, comprising 96 with P. falciparum malaria, 71 with P. vivax malaria, and 52 with DHF. We evaluated the study groups’ baseline clinical features and alterations of platelet indices during the first 4 days of admission.ResultsUpon admission, the initial laboratory findings showed no statistically significant difference in platelet count (PC), plateletcrit (PCT), or platelet distribution width (PDW) between patients with P. vivax and P. falciparum; however, mean platelet volume (MPV) was significantly higher in patients with P. falciparum. Comparisons of the initial platelet indices in malaria and DHF showed that only PC and PCT were significantly lower in DHF. Although MPV in DHF tended to be lower than in malaria, a statistically significant difference was observed only with P. falciparum. Moreover, the results also showed no significant alterations in the platelet indices among the study groups during the first 4 days of admission.Conclusions and recommendationsClinical presentations of DHF and malaria are nonspecific and may overlap with other common tropical diseases. Alterations of initial platelet indices may be investigated in P. vivax and P. falciparum malaria mimicking DHF. Although a significant reduction in PC and PCT in DHF might be a clue for differential diagnosis of malaria, the use of MPV and PDW might be impractical. We suggest that appropriate laboratory diagnoses for malaria and dengue infections are still needed for the differential diagnosis of acute febrile patients who have a risk of malaria or dengue infections. To clarify the clinical utility of platelet indices in patients with dengue and malaria, further studies are required that particularly include patients with different severities, geographical areas, and levels of health care settings.

Clinical use of mean platelet volume and neutrophil-to-lymphocyte ratio to predict prognosis in heart failure with preserved ejection fraction patients

Abstract Background Over the last decade, a new paradigm for heart failure with preserved ejection (HFpEF) development has been proposed. High burden of comorbidities would lead to a systemic inflammatory state and enhanced platelet activation. High platelet reactivity could be associated with higher mean platelet volume (MPV) due increased circulating immature platelets. Moreover, neutrophil-to-lymphocyte (NLR) reflects systemic inflammation. Both parameters have been associated with morbidity and mortality in heart failure (HF). However, data in HFpEF are limited. Purpose We aim to investigate the use of MPV and NLR to predict clinical outcome in HFpEF patients. Methods We prospectively enrolled 228 patients with HFpEF (79±9 years, 66% female patients) and 38 controls of similar age and gender (78±5, 63% female patients). All subjects underwent a complete two-dimensional echocardiography. Mean platelet volume and NLR were measured at baseline. Patients were followed over time for a primary end point of all-cause mortality or first HF hospitalization. The prognosis impact of MPV and NLR were determined with Cox proportional hazard models. Results Mean MPV and median NLR were significantly higher in HFpEF patients compared to controls (MPV: 11.7±1.1 fL vs 10.0±1.1 fL, p=0.005; NLR: 3.3 [2.2; 5.0] vs 2.2 [1.9; 2.9], p<0.001). HFpEF patients with MPV >75th percentile (n=56) had more frequently a history of ischemic cardiomyopathy (46%, p=0.04). HFpEF patients with NLR >75th percentile (n=57) were more frequently in New York Heart Association functional (NYHA) III or IV class (58%, p=0.02) and had higher levels of NT-proBNP (2152 [1336; 6397] pg/mL vs 1690 [705; 3304] pg/mL, p=0.02). Over a median follow-up of 26 months [11.5–56.7 months], 136 HFpEF patients (60%) reached the composite end point (87 deaths and 107 hospitalizations for HF). In univariate Cox regression analysis for the primary end point, MPV >75th percentile (HR: 1.45 [0.99; 2.13], p=0.05) and NLR >75th percentile (HR: 1.59 [1.11; 2.28], p=0.01) were predictors of the primary composite endpoint. In multivariate Cox regression analysis, mean platelet volume >75th percentile (χ2=8.11, P=0.004), continuous MPV (χ2=4.64, P=0.03) provided significant additional prognostic value over a baseline model created using independent predictors of the primary composite end point: body mass index (BMI), NYHA class III or IV, chronic obstructive pulmonary disease (COPD), loop diuretics, estimated glomerular filtration rate (eGFR) and NT-proBNP. By contrast, NLR did not provide any additional information (Figure 1 and 2). Conclusion MPV level and NLR were significantly higher in HFpEF patients compared with controls of similar age and gender. Elevated MPV offers an additional prognostic indication for clinicians and more interestingly it supports the hypothesis that of platelet activation could be involved in disease pathophysiology in HFpEF. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Fondation Saint-Luc

Bibliometric Analysis of Studies on Mean Platelet Volume (MPV) in the Web of Science Database

Background: Mean platelet volume (MPV) was investigated by many medical disciplines for different disease groups. But, the use of MPV values in clinical practice is limited. In this study, it is aimed to make a bibliometric analysis of studies on MPV over the Web of Science database and also to reveal Turkey's contribution to this issue. 
 Materials and methods: This bibliometric analysis was performed in June 2021 as a result of a search for mean platelet volume (MPV) in all indexes in the Web of Science (WOS) database. 
 Results: The most of the MPV studies in the world were conducted on hematology (1256, 18.9%), general internal medicine (746, 11.2%), peripheral vascular diseases (579, 8.7%), cardiology/cardiovascular system diseases (537, 8%), experimental medicine research departments (376, 5.6%), and surgical sciences (342, 5.1%) in the fields of science/subject. The rank of emergency medicine is 64 (0.9%) in the world and 41 (2.1%) in Turkey. 17 of the 25 authors who published the most were Turkish. 
 Conclusion: In many studies, when the standard deviations are taken into account, the difference between the groups cannot be seen mathematically, even if they are statistically different. Therefore, the use of MPV

Mean platelet volume is useful for predicting weaning failure: a retrospective, observational study

BackgroundTo evaluate the usefulness of mean platelet volume (MPV), a marker of inflammation and stress, for predicting weaning failure in patients undergoing invasive mechanical ventilation (IMV) compared to traditional inflammation markers.MethodsThe retrospective observational study including patients who received IMV and underwent spontaneous breathing trial (SBT) was conducted in ICU at Beijing Chao-Yang hospital in China from January, 2013 to December, 2019. According to the weaning outcome, MPV, leukocyte count and C-reaction protein(CRP) were compared between weaning failure and weaning success group. Receiver-operating characteristics (ROC) curves and multivariate logistical regression analysis were constructed to analyze the value of these inflammatory markers for predicting weaning failure.ResultsA total of 261 patients were enrolled in the study and 54 patients (20.7%) experienced weaning failure (45 SBT failure and 9 extubation failure after successful SBT). MPV was a better predictor for weaning failure (AUC 0.777;95%CI, 0.722–0.826) than leukocyte count (AUC 0.6;95%CI,0.538–0.66) and CRP (0.627;95%CI,0.565–0.685). The cutoff value of MPV for predicting weaning failure was 11.3 fl with sensitivity 55.56%, specificity 87.92%, and diagnostic accuracy 81.22%. According to multivariate logistic regression analyses, MPV > 11.3 fl was an independent risk factor for predicting weaning failure.ConclusionsMPV could be a more valuable marker for predicting weaning failure. and the patients with MPV > 11.3 fl should be attentively evaluated before weaning since they are at high risk of weaning failure, and it would be auspicable for those patients to undergo a noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation or even an early tracheostomy.

Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis

The aim of this study is to evaluate and compare the diagnostic ability of platelet-related parameters and white cell-based parameters in pregnant women with appendicitis. This is a retrospective case-controlled study. Women aged between 18 and 50-years-old who had undergone appendectomy between January 2010 and January 2021 were enrolled in the study. Age, pathological diagnosis and relevant laboratory parameters were recorded for each patient. Gestational characteristics were recorded for pregnant patients. There were 58 pregnant and 1171 non-pregnant women enrolled. Pregnant women with acute appendicitis were significantly younger (p < .0001, d= −0.532), had significantly lower PLT (p = .002, d= −0.428) and ALC (p = .033, d= −.304) levels but had significantly higher MPV (p = .004, d = .415) levels than non-pregnant counterparts. In pregnant women, only MPV was the independent predictor of acute appendicitis (OR: 1,952). MPV cut-off value of 9,6 fL provided 63,5% sensitivity, 67,7% specificity, 94,2% PPV and 17,3% NPV whereas 10 fL provided 55,8% sensitivity, 100% specificity, 100% PPV and 21,4% NPV for acute appendicitis in pregnant women. Therefore, MPV might be useful for diagnosing acute appendicitis in pregnant women. Impact statement What is already known on this subject? In pregnant women, counts and percentages of white blood cells and neutrophils are known to be independent predictors of acute appendicitis. Meanwhile, physiologic leukocytosis of gestation is a challenge for interpretation of these parameters. Platelets and related markers are, as well, predictive for inflammatory processes in the human body. What do the results of this study add? The role of platelet-related markers in the diagnosis of acute appendicitis in pregnant women has not been studied previously. The results of the present study indicate that in pregnant women, changes in mean platelet volume might be an independent predictor of acute appendicitis. What are the implications of these findings for clinical practice and/or further research? Further similar large-scale case-controlled or cohort studies are required to validate the present results. In pregnant women with abdominal pain, the use of mean platelet volume as a biomarker could reduce negative laparotomy rates. A mean platelet volume is a useful tool for diagnosing acute appendicitis in pregnant women and provides helpful guidance for clinicians dealing with these patients in the emergency room.

Specific Tests and Inflammatory Biomarkers in the Evaluation of Brucellosis Disease

Brusellosis is the world's most common bacterial zoonotic infection and is still endemic in many developing countries. The clinical appearance of brucellosis is not specific, but the course and severity of the infection varies. In this study, it was aimed to determine the relationship between laboratory parameters and clinical response and organ involvement in patients with Brucellosis diagnosed with specific diagnostic tests. In the study, 100 patients without previous diagnosis of Brucellosis who have admitted to the Department of Infectious Diseases and Clinical Microbiology and had positive Brucella tube agglutination tests and whose clinic was compatible with Brucellosis were evaluated prospectively. Patients were invited to be checked in the 1st, 2nd and 6th weeks . Patients with hip pain and low back pain were evaluated with sacroiliac magnetic resonance imaging (MRI) and lumbar MRI for sacroiliitis and spondylodiscitis. Patients with liver and bone marrow involvements, sacroiliitis, spondylodiscitis and orchitis were recorded as the patients with organ involvement. After six weeks, the decline of the complaints was considered as a clinical response. In the 6th week of the treatment, it was observed that platelet distribution width (PDW) and mean platelet volume (MPV) levels were lower in patients with a clinical response compared to the patients with no clinical response which was statistically significant (p= 0.01, p= 0.02). Platelet and platelet lymphocyte ratio (PLR) level in patients with organ involvement in the 1st and 6th weeks of the treatment, were observed to be lower than the patients without organ involvement which was statistically significant (week 1: p= 0.001, p= 0.01; week 6: p= 0.03, p= 0.01). Among patients with organ involvement and non-organ involvement, the area under the curve was 66% in the ROC curve analysis for PLR at the onset of the treatment. When the cut-off value was taken as 128.8%, the sensitivity was 55%, and the specificity was 78%. Depending on the level of platelet at the beginning of the treatment, in the ROC curve analysis carried out among patients with organ involvement and non-organ involvement, the area under the curve was 73% and when the cut off value was taken as 256000, the sensitivity was 71%, and the specificity was 68%. In the 6th week of the treatment, the area under the curve was observed as 67% in the ROC curve analysis of the PDW level among patients from whom clinical responses were received and not received. When the cut-off value was taken as 10.75%, the sensitivity was 65%, and the specificity was 70%. In the ROC curve analysis of the MPV value for clinical response, the area under the curve was 66%, and when the cut-off value was taken as 9.95, the sensitivity was observed as 52%, and the specificity was 74%. As a result, in the evaluation of the clinical response, which is important in the termination of the treatment in patients with Brucellosis, the use of MPV and PDW values in the evaluation of organ involvement and platelet level and PLO in the follow up, are cheap, easily accessible biomarkers that can be used clinically.

Platelet Activity and Its Correlation with Inflammation and Cell Count Readings in Chronic Heart Failure Patients with Reduced Ejection Fraction.

Background and objectives: There has been an increasing interest in the role of inflammation in thrombosis complications in chronic heart failure (HF) patients. The incidence of thrombosis in HF has been shown to be the highest in patients classified as NYHA IV (New York Heart association). It is stated that inflammation is regulated by platelet-induced activation of blood leukocytes. We aimed to compare the platelet and cell count readings in chronic HF with reduced ejection fraction (HFrEF) patients according to NYHA functional class and to evaluate the correlation between those readings. Materials and methods: A total of 185 patients were examined. The results of heart echoscopy (TEE) testing; fibrinogen, N-terminal pro b-type natriuretic peptide (NT-proBNP), C reactive protein (CRP), and cortisol concentrations; complete blood counts; and a 6 min walking test were assessed and platelet aggregation was determined. Results: Mean platelet volume (MPV) increased with deterioration of a patient’s state (p < 0.005). Lymphocyte count and percentage were the lowest in the NYHA IV group (p < 0.005). Neutrophil and monocyte percentage and count were the highest (p < 0.045) in the NYHA IV group. Adenosine diphosphate (ADP)- and ADR-induced platelet aggregation was higher in the NYHA III group compared to NYHA II and I groups (p < 0.023). NYHA functional class correlated with mean platelet volume (MPV) (r = 0.311, p = 0.0001), lymphocyte count (r = −0.186, p = 0.026), monocyte count (p = 0.172, p = 0.041), and percentage (r = 0.212, p = 0.011). CRP concentration correlated with NT-proBNP (r = 0.203, p = 0.005). MPV correlated with fibrinogen concentration (r = 0.244, p = 0.004). Conclusions: (1) MPV could be considered as an additional reading reflecting a patient’s condition, however the use of MPV to identify patients at risk of hypercoagulable state should be evaluated in more extensive studies; (2) increased neutrophil and monocyte counts could indicate a higher inflammatory state in chronic HFrEF.

Is mean platelet volume the earliest diagnostic marker of neonatal sepsis: a prospective case control study

Background: Neonatal sepsis is the third leading cause of neonatal mortality after prematurity and intrapartum related complications worldwide. The literature regarding the use of Mean platelet volume as a diagnostic tool in neonatal sepsis is scanty.Methods: Prospective case control study in a district hospital. Neonates &gt; 30 weeks gestation admitted to NICU during the study period were included. Neonates who did not have any risk factors for sepsis and did not have a positive blood culture or elevated CRP were categorized as group 1. Neonates who were admitted with risk factors of sepsis but did not have a positive CRP or blood culture positivity were categorized as group 2. Neonates who were admitted as probable sepsis and subsequently developed blood culture or CRP positivity were categorized as group 3.Septic workup was done for all the subjects at admission and at 72 hours after admission. Newborn with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 20.0.Results: Total 240 Neonates were included in the study. Elevation of MPV in neonates with sepsis was seen as early as the first sample whereas CRP elevation was seen only on Day 3. Cut off value for Mean Platelet Volume (MPV) was found to be 10.15fl with sensitivity of 84% and specificity of 74%.Conclusions: MPV can be used as a earliest diagnostic marker for prediction of neonatal sepsis and mortality. It can facilitate early initiation of treatment without any additional exposure.

Diagnostic Role of Mean-Platelet Volume in Acute Pulmonary Embolism: A Meta-analysis and Systematic Review.

Background:Acute pulmonary embolism (PE) is the third most fatal cardiovascular disease. PE is frequently misdiagnosed due to its clinical presentation’s heterogeneity and the inexistence of biomarkers for its immediate diagnosis. Mean platelet volume (MPV) has shown a potential role as a biomarker in acute PE. In this analysis, we aimed to systematically compare the MPV in patients with and without definite diagnosis of PE, in emergency departments.Methods:Embase, PubMed and Medline were searched for relevant publications, in English. The main inclusion criteria were studies which compared MPV in patients with acute PEA versus a control group.Results:Thirteen studies consisting of a total number of 2428 participants were included. Of the participants included, 1316 were patients with confirmed acute PE, and 1112 were assigned to the control group. MPV was significantly higher in patients with acute PE than in controls (RR: 0.84, 95% CI: 0.76 – 0.92; P < .00001). There was a significant heterogeneity in the data.Conclusions:This analysis showed higher MPV to be associated with acute PE immediate diagnosis. These data show promise for the use of MPV as a readily available biomarker for the diagnosis of acute PE at the emergency department.

Usefulness of mean platelet volume to platelet count ratio for predicting the risk of mortality in community-acquired pneumonia.

IntroductionThe association between mean platelet volume (MPV) to platelet count (PC) ratio and prognosis has been demonstrated in some diseases but not in community-acquired pneumonia (CAP). In this study, we evaluated the ability of MPV to PC ratio (MPR) to predict short-term mortality in CAP patients.Material and methodsWe retrospectively analysed data archived over 10 years and stratified MPR values into quartiles. Relations between MPR (femtoliters/number of thousand platelets per microlitre) quartiles and 60-day mortality were examined. Logistic regression was performed to adjust for confounders, and the Kaplan-Meier method was used for survival analysis.ResultsAfter adjusting for confounding factors, the odds ratios of 60-day mortality for CAP were 2.66 (95% CI: 2.04–3.46) for the fourth MPR quartile (range ≥ 5.19; p < 0.001) versus the first MPR quartile (range ≤ 2.45). Kaplan-Meier curves indicated that a higher MPR was associated with a higher risk of mortality among CAP patients, and this was confirmed by the log-rank test (p < 0.001).ConclusionsMean platelet volume to PC ratio was found to be positively correlated with short-term mortality. Our data indicate that MPR might be a significant predictive marker of the mortality in CAP. Further prospective studies are required to establish the exact role of MPR in CAP and other diseases.

Diagnostic Accuracy of the Mean Platelet Volume in the Prediction of Upper Urinary Tract Infections.

The studies have reported that mean platelet volume may be a marker in the discrimination of upper and lower urinary tract infections. We investigated whether the mean platelet volume was a reliable indicator in upper and lower urinary tract infections. One hundred and eighty-two patients between the ages of 1 month and 14 years who were diagnosed with urinary tract infection were included in this study. The mean platelet volume values, clinical and other laboratory characteristics of the groups were compared. The discriminative ability of each biomarker for patients with UUTI was evaluated by drawing receiver operating characteristic (ROC) curves for the biomarkers. All values of p < 0.05 were considered statistically significant. The leukocyte count, C-reactive protein, and erythrocyte sedimentation rates of the patients with upper urinary tract infection were significantly higher than the patients with lower urinary tract infections (p < 0.001). However, there was no statistically significant difference in terms of the mean platelet volume values between patients with upper and lower urinary tract infection ([7.2 (1.3) vs. 7.2 (1.6) fL]; p = 0.79, respectively). The value of the area under the curve of MPV's p-value was > 0.05. However, p-values of CRP and ESR were significant in ROC analysis. Our study showed that there was no significant difference in the mean platelet volume values between patients with upper and lower urinary tract infections. The use of mean platelet volume as an indicator of upper urinary tract infection is controversial.

Platelet levels and neutrophil to lymphocyte ratio in thyroid nodules with and without cancer diagnosis

Nodular formation of thyroid tissue is a very common endocrinologic pathology. Approximately 5% of thyroid nodules can prove to be cancerous. The usefulness of mean platelet volume(MPV) and neutrophil to lymphocyte ratio (NLR) is determined as an indicator of immunological response and subclinical inflammation in recent years. In this study we evaluate the association of thyroid stimulating hormone (TSH), platelet, mean platelet volume(MPV) and NLR levels between the thyroid nodules that turn into cancer and do not convert. Our study consisted of patients with thyroid nodules that converted to thyroid cancer (n = 100) and didn’t convert to thyroid cancer (n = 100). These patients were selected retrospectively using the Hospital Information System. The TSH, NLR, platelet and MPV levels were recorded preoperatively and the difference between them was evaluated statistically with SPSS 21. Differences between groups were examined with using Mann Whitney U Test. P

Usefulness of mean platelet volume as a biomarker for diagnosing arterivenosus fistulas thrombosis in routine hemodialysis patients

Aim: Hemodialysis patients should have an access to a vessel. Thrombosis is responsible for 80-85% of fistula losses. Mean Platelet Volume (MPV) is routinely measured in complete blood count and shows the average volume of circulating platelets. In our study, we aimed to investigate whether MPV values may be used as a cheap and noninvasive marker in the early diagnosis and intervention of arteriovenous fistula (AVF) thrombosis.Material and Methods: This retrospective study included 48 patients having one or more episodes of late fistula thrombosis at the hemodialysis unit and 47 patients without history of AVF thrombosis.Results: Demographic and laboratory characteristics were used to compare between groups and no significant difference was found (p> 0.05). On the other hand, significant difference was reported (p=0.001) by the comparison of two groups. Logistic regression analysis, revealed that MPV was an independent risk predictor for the development of AVF thrombosis (p 0.05).Conclusion: AVF dysfunction leads to a significant cost and frequent hospitalization of the patient. Previously, MPV was stated to be a risk factor for arterial and venous thrombosis. This study showed that MPV values may be used in hemodialysis patients as a predictor of thrombosis. Further prospective and retrospective studies should be conducted in order to verify the finding of this study.

The role of complete blood count parameters in diagnosing acute appendicitis and measuring the severity of inflammation.

The diagnosis and severity of acute appendicitis (AA) are still challenging despite all the improvements in diagnosis and treatment. This study aimed to evaluate the efficacy of complete blood count (CBC) parameters in diagnosing AA and measuring severity. Data of 521 patients were reviewed retrospectively. Fifty-three patients with CBC results influenced by various reasons were excluded from the study. Age, gender, length of stay, CBC parameters, and histopathological results were examined. The study included 468 patients: 90 patients with a preliminary diagnosis of AA, not undergoing surgery but receiving medical treatment (Group I), 227 patients with uncomplicated appendicitis (Group II), and 151 patients with complicated appendicitis (Group III). Of the patients, 279 were male (59.6%) and 189 were female (40.4%). The mean age was 33.37±13.05 years. Groups I and III had the lowest and highest white blood cell (WBC), neutrophil, and neutrophil-to-lymphocyte ratio (NLR), respectively. There was a statistically significant difference between the groups (p<0.05). The highest and lowest mean platelet volume (MPV) values were in Groups II and III, respectively. There was no statistically significant difference between the groups (p>0.05). AA is the most common cause of abdominal surgery. The CBC is a cost-effective and easily-accessible test with acceptable diagnostic accuracy. It provides fast results and can be used in the diagnosis of appendicitis. Neutrophil, WBC, and NLR are helpful and useful parameters for physical examination and other diagnostic methods in diagnosing AA and measuring severity. However, the use of MPV is not recommended as it has a low diagnostic rate and contradictory results.

Usefulness of mean platelet volume and neutrophil-to-lymphocyte ratio for development of atrial fibrillation after acute myocardial infarction

Objective: Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevated myocardial infarction (STEMI). Mean platelet volume (MPV) is an indicator of platelet activation and function. Mean platelet volume has been identified as an independent risk factor for future stroke and myocardial infarction. The neutrophil-to-lymphocyte ratio (NLR), fast and easy method for detecting inflammatory status, have been recently explored as a predictor for cardiovascular risk and AF. The aim of the present study was to evaluate a possible relationship between NLR and MPV levels on development of AF after STEMI.Methods: This prospective study consisted of 743 patients with acute STEMI who were admitted to coronary care unit. Patients were divided into two groups, patients with and without AF. Predictors of AF were determined by multivariate regression analysis.Results: From a total of 743 patients presenting with STEMI, 82 (11%) developed AF. Mean platelet volume and NLR was significantly higher in patients with AF compared to without AF (p&amp;lt;0.001, respectively). Multivariate regression analysis results showed that, age [Odds Ratio (OR)=1.03; 95% Confidence Interval (CI)=1.01-1.05; p=0.001), ejection fraction (OR=0.95; 95% CI=0.93-0.98; p&amp;lt;0,001), MPV (OR=1.738; 95% CI=1.29-2.33; p&amp;lt;0.001), NLR (OR=1.08; 95% CI=1.01-1.15; p=0,025) and previous angiotensinogen converting enzyme blockers (OR=3.04; 95% CI=1.22-7.54; p=0,017) using were associated with development of AF in patients with acute STEMI. Conclusions: This study showed that, MPV and NLR were associated with the development of AF in patients presenting STEMI, other independent predictors of AF included age, and ejection fraction.