Trombosit Kütle İndeksinin Toplum Kökenli Pnömonide Kısa Dönem Mortaliteyi Öngörmedeki Rolü: Analitik Bir Çalışma

Öz

Giriş: Toplum kökenli pnömoni (CAP), özellikle yaşlı hastalar ve komorbiditeleri olan bireyler arasında dünya çapında önemli bir morbidite ve mortalite nedenidir. Erken risk sınıflandırması, tedavi kararlarını optimize etmek için kritik öneme sahiptir. Trombositler, hemostaz ve inflamasyonda kilit rol oynar ve trombositle ilişkili indeksler potansiyel prognostik belirteçler olarak araştırılmaktadır. Trombosit Kütle İndeksi (PMI), trombosit sayısı × ortalama trombosit hacmi (MPV) olarak hesaplanır ve inflamatuvar şiddetin bir göstergesi olarak önerilmiştir. Bu çalışma, hastanede yatan CAP hastalarında kısa dönem mortaliteyi öngörmede PMI'nin prognostik değerini değerlendirmeyi amaçlamaktadır. Yöntemler: Bu retrospektif gözlemsel çalışma, 1 Ocak 2023 ile 1 Ocak 2024 tarihleri arasında hastaneye yatırılan ve CAP tanısı alan yetişkin hastaları içermektedir. Demografik veriler, klinik parametreler, laboratuvar bulguları ve şiddet skorları (PSI, CURB-65) toplanmıştır. PMI değerleri, sağ kalanlar ve sağ kalmayanlar arasında karşılaştırılmıştır. İstatistiksel analizler Mann-Whitney U testi, ki-kare testi ve lojistik regresyonu içermektedir. Modelin prediktif performansı, ROC eğrisi analizi kullanılarak değerlendirilmiştir. Bulgular: Toplam 174 CAP hastası (%67 erkek, ortanca yaş 77) analiz edilmiştir. En yaygın semptom dispne (%82) olarak bulunmuştur. Sağ kalanlar ve sağ kalmayanlar arasında PMI açısından anlamlı bir fark gözlenmemiştir (p=0,33). Daha yüksek PSI ve CURB-65 skorları, düşük albümin seviyeleri ve yüksek solunum hızları artmış mortalite ile ilişkilendirilmiştir. Mortaliteyi öngörmede kullanılan modelin AUC değeri 0,814 olarak bulunmuştur. Sonuç: PMI, hastanede yatan CAP hastalarında kısa dönem mortaliteyi öngörmede anlamlı bir belirteç değildir. Şiddetli vakalardaki inflamatuvar yanıt ve potansiyel karıştırıcı faktörler sonuçları etkilemiş olabilir. PMI'nin prognostik rolünü netleştirmek için daha geniş hasta popülasyonlarında ileri prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Toplum kökenli pnömoni
• pnömoni
• mortalite
• trombosit
• ortalama trombosit hacmi

The Role of Platelet Mass Index in Predicting Short-Term Mortality in Community-Acquired Pneumonia: An Analytical Study

Abstract

Introduction: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide, particularly among elderly patients and those with comorbidities. Early risk stratification is crucial for optimizing treatment decisions. Platelets play a key role in hemostasis and inflammation, and platelet-related indices have been investigated as potential prognostic markers. The Platelet Mass Index (PMI), calculated as platelet count × mean platelet volume (MPV), has been proposed as a marker of inflammatory severity. This study aims to evaluate the prognostic value of PMI in predicting short-term mortality in hospitalized CAP patients. Methods: This retrospective observational study included adult patients diagnosed with CAP and hospitalized between January 1, 2023, and January 1, 2024. Demographic data, clinical parameters, laboratory findings, and severity scores (PSI, CURB-65) were collected. PMI values were compared between survivors and non-survivors. Statistical analyses included Mann-Whitney U tests, chi-square tests, and logistic regression. The predictive performance of the model was assessed using ROC curve analysis. Results: A total of 174 CAP patients (67% male, median age 77 years) were analyzed. The most common symptom was dyspnea (82%). No significant difference in PMI was observed between survivors and non-survivors (p=0.33). Higher PSI and CURB-65 scores, lower albumin levels, and elevated respiratory rates were associated with increased mortality. The predictive model for mortality demonstrated an AUC of 0.814. Conclusion: PMI was not a significant predictor of short-term mortality in hospitalized CAP patients. The inflammatory response in severe cases and potential confounders may have influenced the results. Further prospective studies in broader patient populations are needed to clarify PMI’s prognostic role.

Keywords

• Community-acquired pneumonia
• pneumonia
• mortality
• platelet
• mean platelet volume

Kaynakça

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