An increase in mean platelet volume (MPV) as a predictor of mortality in children with sepsis

https://doi.org/10.19106/JMedSci005401202202

Rianti Puji Lestari(1), Sumadiono Sumadiono(2), Eggi Arguni(3*)

(1) Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Sepsis is associated with increased morbidity and mortality in children worldwide, mainly in developing countries. This fatal risk emphasizes the importance of finding accessible and inexpensive parameters to be used as predictors for mortality in children with sepsis. The aim of this study was to determine the role of increased mean platelet volume (MPV) as a predictor for mortality in children with sepsis.  A case control study was applied using medical records of all in-patients aged 1 mo -18 y diagnosed with sepsis at Dr. Sardjito General Hospital, Yogyakarta from January 2015-December 2016. Bivariate and multivariate analyses by Chi-square and logistic regression to evaluate the correlations between increased MPV within the first 24-72 h (ΔMPV>0) and mortality were applied. Eighty-one eligible subjects met the inclusion/exclusion criteria with the mortality was 52%. Chi-square analysis showed significant correlations between increased MPV and mortality (p=0.005). Multivariate analysis showed increased MPV within the first 24-72 h after sepsis diagnosis as a predictor for mortality after controlling for sex and AKI (adjusted OR 3.851; 95% CI:1.354-10.948; p= 0.011). In conclusion, an increase in MPV within the first 24-72 h after diagnosed is an independent predictor for mortality in children with sepsis.


Keywords


children; mean platetet volume; mortality; sepsis

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References


1. Latief A, Chairulfatah A, Alam A. Pedoman Nasional Pelayanan Kedokteran Ikatan Dokter Anak Indonesia: diagnosis dan tata laksana sepsis pada anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia, 2016.
2. Shime N, Kawasaki T, Saito O, Akamine Y, Toda Y, Takeuchi M, et al. Incidence and risk factors for mortality in paediatric severe sepsis: results from the national paediatric intensive care registry in Japan. Intensive Care Med 2012; 38(7):1191-7.
https://doi.org/10.1007/s00134-012-2550-z
3. Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003; 167(5):695-701.
https://doi.org/10.1164/rccm.200207-682OC
4. Saraswati DD, Pudjiadi AH, Djer MM, Supriyatno B, Syarif DR, Kurniati N. Faktor risiko yang berperan pada mortalitas sepsis. Sari Pediatri 2014; 15(5):281-8.
https://doi.org/10.14238/sp15.5.2014.281-8
5. Prihardi MT, Hanafie A, Harto S. Hubungan nilai mean platelet volume (MPV) dengan Skor APACHE II sebagai prediktor mortalitas pada pasien sepsis berat di Rumah Sakit Umum Pusat Haji Adam Malik Medan. J Anastesi Perioper 2016; 4(3):177-82.
https://doi.org/10.15851/jap.v4n3.901
6. Becchi C, Al Malyan M, Fabbri LP, Marsili M, Boddi V, Boncinelli S. Mean platelet volume trend in sepsis: is it a useful parameter? Minerva Anestesiol 2006; 72(9):749-56.
7. Tajarernmuang P, Phrommintikul A, Limsukon A, Pothirat C, Chittawatanarat K. The role of mean platelet volume as a predictor of mortality in critically ill patients: a systematic review and meta-analysis. Crit Care Res Pract 2016; 2016:4370834.
https://doi.org/10.1155/2016/4370834
8. Eberhardt A, Lessig F, Schreiter K, Kelner N, Fuchs M, Ludewig M, et al. Mean platelet volume (MPV) is an outcome marker in sepsis patients. Intern J Infect Dis 2012; 16(Suppl 1):e281.
https://doi.org/10.1016/j.ijid.2012.05.813
9. Catal F, Tayman C, Tonbul A, Acka A, Kara S, Tatli MM, et al. Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants. Clin Lab 2014; 60(7):1193-200.
https://doi.org/10.7754/clin.lab.2013.130501
10. Kim CH, Kim SJ, Lee MJ, Kwon YE, Kim YL, Park KS, et al. An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PLoS One 2015; 10(3):e0119437.
https://doi.org/10.1371/journal.pone.0119437
11. Sadaka F, Donnelly PL, Griffin MT, O’Brien J, Lakshmanan R. Mean platelet volume is not a useful predictor of mortality in septic shock. J Blood Disord Transf 2014; 5(2):194.
https://doi.org/10.4172/2155-9864.1000194
12. Wilar R, Antolis Y, Tatura SNN, Gunawan S. Jumlah trombosit dan mean platelet volume sebagai faktor prognosis pada sepsis neonatorum. Sari Pediatri 2010; 12(1):53-7.
https://dx.doi.org/10.14238/sp12.1.2010.53-7
13. Alatas H. Gagal ginjal akut. In: Noer MS, Soemyarso NA, Subandiyah K, Prasetyo RV, Alatas H, Tambunan T, et al. Kompendium Nefrologi Anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011. 72-88.
14. Khemani RG, Bart RD, Alonzo TA, Hatzakis G, Hallam D, Newth CJL. Disseminated intravascular coagulation score is associated with mortality for children with shock. Intensive Care Med 2009; 35(2):327-33.
https://doi.org/10.1007/s00134-008-1280-8
15. Singer M, Deutschman CS, Seymour CW, Hari MS, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315(8):801-10.
https://doi.org/10.1001/jama.2016.0287
16. Pigozzi L, Aron JP, Ball J, Cecconi M. Understanding platelet dysfunction in sepsis. Intensive Care Med 2015; 42(4):583-6.
https://doi.org/10.1007/s00134-015-4012-x
17. Allen S, Pena LED. Hematology: blood coagulation test. In: Lee M, editor. Basic skills in interpreting laboratory data. 4th ed. Maryland: American Society of Health-System Pharmacist, 2009.
18. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital J Pediatr 2013; 39:16.
https://doi.org/10.1186/1824-7288-39-16
19. Erdoğan S, Oto A, Boşnak M. The relation between mean platelet volume and mortality in critical pediatric patients. Turk J Pediatr 2015; 57(6):605-10.
20. Fitzgerald JC, Basu RK, Akcan-Arikan A, Izquierdo LM, Olave BEP, Hassinger AB, et al. Acute kidney injury in pediatric severe sepsis: an independent risk factor for death and new disability. Crit Care Med 2016; 44(12):2241-50.
https://doi.org/10.1097/CCM.0000000000002007
21. Patriawati KA. Kadar laktat serial sebagai faktor prognosis mortalitas pasien sepsis [Thesis]. Yogyakarta: Universitas Gadjah Mada, 2013.
22. Wynn J, Cornell TT, Wong HR, Shanley TP, Wheeler DS. The host response to sepsis and developmental impact. Pediatrics 2010; 125(5):1031-41.
https://doi.org/10.1542/peds.2009-3301
23. Pietropaoli AP, Glance LG, Oakes D, Fisher SG. Gender differences in mortality in patients with severe sepsis or septic shock. Gend Med 2010; 7(5):422-37.
https://doi.org/10.1016/j.genm.2010.09.005
24. de Prost N, Razazi K, Brun-Buisson C. Unrevealing culture-negative severe sepsis. Crit Care 2013; 17(5):1001.
https://doi.org/10.1186/cc13022
25. Dastjerdi MS, Emami T, Najafian A, Amini M. Mean platelet volume measurement, EDTA or citrate? Hematology 2006; 11(5):317-9.
https://doi.org/10.1080/10245330600954163



DOI: https://doi.org/10.19106/JMedSci005401202202

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