Evaluation and Importance of Platelet Variability Index Diagnostic Value in Cerebrovacular Events

Öz

Objective: Since mortality and morbidity rates due to acute stroke are high, it is important to predict early prognosis in these patients. The relationship between mean platelet volume (MPV), Platelet (PLT) and MPV/PLT values of patients diagnosed with ischemic or hemorrhagic stroke in the emergency department, and demographic characteristics, triage code, outcome, vital parameters of patients, and Glasgow Coma Scale (GCS) were tried to be evaluated. Materials and Methods: This study was carried out retrospectively on 200 patients over the age of 18 who applied to the 3rd Stage University Hospital Emergency Department and were diagnosed with ischemic or hemorrhagic stroke as a result of the examinations. Results: A total of 200 patients, 116 (58%) of whom were men, were included in our study. The mean age of the patients was 68 years. It was seen that 178 (89%) of the patients were diagnosed with ischemic stroke and 22 (11%) with hemorrhagic stroke. A correlation was found between the patients'age and MPV / PLT ratios (p <0.05). Systolic and diastolic blood pressure of the patients are evaluated; a correlation was found between MPV / PLT ratio and systolic blood pressure values, it is statistically significant (p <0.05). Conclusion: In our study, we tried to evaluate the relationship between MPV, PLT and MPV / PLT values of patients admitted to the emergency department with ischemic stroke or hemorrhagic stroke, and the demographic characteristics, triage code, outcome, vital parameters and GCS scores of the patients. In our study, a correlation was found between systolic blood pressure and age of the patients MPV / PLT ratios. No statistically significant correlation was found between the triage code and GCS scores, outcome and MPV/PLT ratios at the time of admission. No significant difference was found between MPV/PLT rates in the ischemic and hemorrhagic stroke groups.

Anahtar Kelimeler

• Hemorrhagic Stroke
• Ischemic Stroke
• Mean Platelet Volume
• Platelet
• Emergency Medicine

Platelet Variability İndex’in Serebrovasküler Olaylardaki Tanısal Değerinin Değerlendirilmesi Ve Önemi

Öz

Giriş ve Amaç: Akut inmeye bağlı mortalite ve morbidite oranları yüksek olduğundan bu hastaların erken prognoz öngörüsünü yapmak önemlidir. Acil serviste iskemik ya da hemorajik inme tanısı alan hastaların Ortalama trombosit hacmi (MPV), Platelet (PLT) ve MPV/PLT değerleri ile hastaların demografik özellikleri, triaj kodu, sonlanımı, hastaların vital parametreleri ve Glaskow Koma Skalası (GKS) arasındaki ilişki değerlendirilmeye çalışılmıştır. Gereç ve Yöntemler: Bu çalışma 3. Basamak Üniversite Hastanesi Acil servisine başvuran 18 yaş üstü, yapılan tetkikler neticesinde iskemik veya hemorajik inme tanısı alan 200 hasta üzerinde retrospektif olarak yapılmıştır. Bulgular: Çalışmamıza 116 (%58)’sı erkek olmak üzere toplam 200 hasta dahil edilmiştir. Hastaların yaş ortalaması 68 yıl olarak tespit edilmiştir. Hastaların 178 (%89)’inin iskemik, 22 (%11)’sinin hemorajik inme tanısı aldığı görüldü. Hastaların yaşı ve MPV/PLT oranları arasında korelasyon bulunmuştur (p<0.05). Hastaların sistolik ve diyastolik kan basınçları değerlendirildiğinde; MPV/PLT ile sistolik kan basıncı değerleri arasında korelasyon bulunmuştur (p< 0.05). Sonuç: Çalışmamızda iskemik ya da hemorajik inme ile acil servise başvuran hastaların MPV, PLT ve MPV/PLT değerleri ile hastaların demografik özellikleri, triaj kodu, sonlanımı, hastaların vital parametreleri ve GKS skorları arasındaki ilişki değerlendirilmeye çalışılmıştır. Çalışmamızda hastaların sistolik kan basıncı, yaşı ile MPV/PLT oranları arasında korelasyon bulunmuştur. Hastaların başvuru anındaki triaj kodu ve GKS skorları, sonlanımı ile MPV/PLT oranları arasında istatiksel açıdan anlamlı bir ilişki bulunamamıştır. İskemik ve Hemorajik inme gruplarında, MPV/PLT oranları arasında anlamlı bir fark bulunamamıştır.

Anahtar Kelimeler

• Acil Servis
• Hemorajik İnme
• İskemik İnme
• Ortalama Trombosit Hacmi
• Platelet

Kaynakça

1. Weinberger, J. Stroke and TIA, Geriatrics, 2002,57, 1.
2. Ozturk, S. Serebrovasküler hastalık epidemiyolojisi ve risk faktörleri-Dünya ve Türkiye perspektifi, Turkish journal of Geriatry, 2009, 13(1), 51-58.
3. Raymond, AD, Victor, M, Ropper, AH, Principles of neurology, In: Cerebrovascular Diseas, 8th ed. New York: McGraw-Hill, 2006, 34, pp 660-667.
4. Sacco, R.L, Pathogenesis, classification, and epidemiology of cerebrovascular disease, Merrit's Textbook of Neurology, 1995, 227.
5. Utku, U, Çelik, Y. Strokta Etyoloji, Sınıflandırma ve risk faktörleri, Ed: Balkan S, Serebrovasküler Hastalıklar, 2009, 51-62.
6. Utku,, U, Çelik Y. Strokta Etyoloji, Sınıflandırma ve risk faktörleri, Ed: Balkan S, Serebrovasküler Hastalıklar, 2005, 167-179.
7. Bamford, J, Dennis, M, Sandercock, P, Burn, J, Warlow, C, The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project, Journal of Neurology, Neurosurgery & Psychiatry, 1990, 53(10), 824-829.
8. Deb, P, Sharma, S, Hassan, K. M, Pathophysiologic mechanisms of acute ischemic stroke: An overview with emphasis on therapeutic significance beyond thrombolysis, Pathophysiology, 2010,17(3), 197-218.

9. Ntaios, G, Gurer, O, Faouzi, M, Aubert, C, Michel, P. Red cell distribution width does not predict stroke severity or functional outcome, International Journal of Stroke, 2012, 7(1), 2-6.
10. Yoneda, Y, Okuda, S, Hamada, R, Toyota, A, Gotoh, J, Watanabe, M. et all., Hospital cost of ischemic stroke and intracerebral hemorrhage in Japanese stroke centers, Health Policy, 2005, 73(2), 202-211.
11. Reganon, E, Vila, V, Martı́nez-Sales, V, Vaya, A, Lago, A, Alonso, P, et all., Association between inflammation and hemostatic markers in atherothrombotic stroke, Thrombosis research, 2003, 112(4), 217-221.
12. Williams, L.S, Bruno, A, Rouch, D, Marriott, D.J, et all. Stroke patients’ knowledge of stroke: influence on time to presentation, Stroke, 1997, 28(5), 912-915.
13. Arrich, J, Müllner, M, Lalouschek, W, Greisenegger, S, Crevenna, R, Herkner, H. Influence of socioeconomic status and gender on stroke treatment and diagnostics, Stroke, 2008, 39(7), 2066-2072.
14. Demirci, S, Yalçıner, B. Z, Bakaç, G, Dayan, C, Aysal, F, Baybaş, S, Risk Factors That Affect Stroke Recurrence, Dusunen Adam The Journal of Psychiatry and Neurological Sciences, 2010, 23(1), 38.
15. Polovina, M, Potpara, T, Giga, V, Stepanović, J, Ostojić, M, Impaired endothelial function in lone atrial fibrillation, Vojnosanitetski pregled, 2013, 70(10), 908-914.
16. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies, Lancet, 2002, 360(9349), 1903-13.
17. Somay, G, Topaloğlu, P, Somay, H, Araal, Ö, Halaç, G.U, Bulkan, M, Cerebrovascular risk factors and stroke subtypes in different age groups: a hospital-based study, Turkish Journal of Medical Sciences, 2006, 36(1), 23-29.
18. Nadar, S.K, Lip, GY, Blann, A.D, Platelet morphology, soluble P selectin and platelet P-selectin in acute ischaemic stroke, Thrombosis and haemostasis, 2004, 92(12), 1342-1348.
19. Kishk, Y. T, Trowbridge, E. A, Martin, J. F. Platelet volume subpopulations in acute myocardial infarction: an investigation of their homogeneity for smoking, infarct size and site, Clinical Science,1985, 68(4), 419-425.
20. Karıo, K, Matsuo, T, Nakao, K, Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis, Clinical & Laboratory Haematology, 1992,14(4), 281-287.
21. Arikanoglu, A, Yucel, Y, Acar, A, Cevik, M. U, Akil, E, Varol, S, et all. The relationship of the mean platelet volume and C-reactive protein levels with mortality in ischemic stroke patients, European Review of Medical Pharmacological Science, 2013, 17(13), 1774-1777.
22. Tamer, D, Fevzi, Y, Deniz, A. E, Cemil, K, Fatih, B, Cihat, Y, et all., The value of serum mean platelet volume in ischaemic stroke patient, Journal of Pakistan Medical Association, 2013, 63(63), 1509-10.
23. O’malley, T, Langhorne, P, Elton, R. A, Stewart, C, Platelet size in stroke patients, Stroke, 1995, 26(6), 995-999.