The importance of mean platelet volume in early mortality of pulmonary embolism

Öz

Objective: In this study whether mean platelet volume (MPV) is associated with early period hospital mortality or not in patients with pulmonary embolism (PE) was investigated. Methods: Data of patients that hospitalized in chest diseases clinic with the diagnosis of PE between the years 2009-2012 were screened retrospectively from digital archive system. The demographic data, symptoms, treatment outcomes and MPV values in complete blood count of patients were recorded. Results: The mean age was 57.93 ± 18.52 years (16-91). The number of patients is 143 and 91 women (63.9%), 52 men (36.4%), respectively. MPV values were available for 137 of 143 patients. 129 of patients were discharged, and 8 had died in the early period of hospitalization. The mean MPV value was 7.85 ± 1.40 fL in patients who experienced and 9.08 ± 1.61 fL in died respectively. The difference was statistically significant (p = 0.01). Conclusion: The results of this study suggests that increased MPV value may be used as a marker for early hospital mortality in patients with PE. J Clin Exp Invest 2013; 4 (3): 298-301

Anahtar Kelimeler

• Mean platelet volume, mortality, pulmonary embolism

Pulmoner emboli erken mortalitesinde ortalama trombosit hacminin önemi

Öz

Amaç: Bu çalışmada ortalama trombosit hacmi (MPV)'nin pulmoner emboli (PE)'li hastalarda erken dönem hastane mortalitesi ile ilişkili olup olmadığı araştırıldı. Yöntemler: 2009-2012 yılları arasında göğüs hastalıkları kliniğinde PE tanısı ile yatırılan hastaların verileri dijital arşiv sisteminden retrospektif olarak tarandı. Hastaların demografik verileri, semptomları, tedavi sonuçları ve tam kan sayımındaki MPV değerleri kaydedildi. Bulgular: Yaş ortalaması 57,93±18,52 yıl (16-91) idi. Hasta sayısı 143 olup, 91'i kadın (%63,9), 52'si erkek (%36,4) idi. 143 hastadan 137\' sinin MPV değerlerine ulaşılabildi. Hastaların 129'u şifa ile taburcu olmuş, 8'i ise hastanede yatışın erken dönemde ölmüştü. Yaşayan hastalarda MPV değeri ortalaması 7,85±1,40 fL, ölenlerde 9,08±1,61 fL idi. Aralarındaki fark istatistiksel olarak anlamlı idi (p= 0,01). Sonuç: Çalışmamızın sonuçları, artmış MPV değerinin PE'li hastalarda erken dönem hastane mortalitesi için bir belirteç olabileceğini düşündürmektedir.

Anahtar Kelimeler

• Ortalama trombosit hacmi, mortalite, pulmoner emboli

Kaynakça

1. Stein PD, Kayali F, Olson RE. Estimated case fatality rate of pulmonary embolism 1979 to 1998. Am J Car- diology 2004; 93: 1197-1199
2. Torbicki A, Perrier A, Konstantinides S. et al. Guidelines on the diagnosis and management of acute pulmo- nary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2008; 29: 2276-2315.
3. Endler G, Klimesch A, Sunder-Plassmann H. et al. Mean platelet volüme is an independent risk factor for myocardial infarction but not for coronary artery dis- ease. Br J Haematol 2002;117: 399-404.
4. Senaran H, Ileri M, Altinbas A. et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001; 24: 405-408.
5. Varol E, Icli A, Uysal BA, Ozaydin M. Platelet indices in patients with acute pulmonary embolism. Scand J Clin Lab Invest 2011; 71: 163-167.
6. Goldhaber SZ. Pulmonary embolism. Lancet 2004; 363: 1295-1305 .
7. Becattini C, Agnelli G. Acute pulmonary embolism: risk stratification in the emergency department Intern Emerg Med. 2007; 2: 119-129.
8. Aujesky D, Perrier A, Roy PM, et al. Validation of a clini- cal prognostic model to identify low-risk patients with pulmonary embolism. J Intern Med 2007; 261: 597- 604.

9. Wicki J, Perrier A, Perneger TV, et al. Predicting ad- verse outcome in patients with acute pulmonary em- bolism: a risk score. Thromb Haemost 2000; 84: 548- 552.
10. Heit JA, Mohr DN, Silverstein MD, et al. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch In- tern Med 2000; 160: 761-768.
11. Torbicki A, Van Beek EJR, Charbonnier B, et al. Guide- lines on diagnosis and management of acute pulmo- nary embolism. Eur Heart J 2000; 21: 1301-1336.
12. Kamphuisen PW, Agnelli G, Sebastianelli M. Preven- tion of venous thromboembolism after acute ischemic stroke. Thromb Haemost 2005; 3: 1187-1194.
13. Rutschmann OT, Cornuz J, Poletti PA, et al. Should pulmonary embolism be suspected in exacerbation of chronic obstructive pulmonary disease? Thorax 2007; 62; 121-125.
14. Howell MD, Geraci JM, Knowlton AA. Congestive heart failure and outpatient risk of venous thrombo- embolism: a retrospective case-control study. J Clin Epidemiol 2001; 54: 810-816.
15. Movahed MR, Hashemzadeh M, Jamal MM. The pre- valance of pulmonary embolism and pulmonary hy- pertansion in patients with type II diabetes mellitus. Chest 2005; 128: 3568-3571.
16. Otten HM, Mathijssen J, ten Cate H, et al. Symp- tomatic venous thromboembolism in cancer patients treated with chemotherapy: An underestimted phe- nomenon. Arch Intern Med 2004; 164:190-4.13.
17. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: Are we detecting enough deep vein thrombosis? J R Soc Med 1989; 82: 203-205 .
18. Mathur A, Robinson MS, Cotton J, Martin JF, Erusa- limsky JD. Platelet reactivity in acute coronary syn- dromes: evidence for differences in platelet behaviour between unstable angina and myocardial infarction. Thromb Haemost 2001; 85: 989-994.
19. Este´vez-Loureiro R, Salgado-Ferna´ndez J, Marzoa- Rivas R, et al. Mean platelet volume predicts patency of the infarct-related artery before mechanical reper- fusion and short-term mortality in patients with ST- segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Thromb Res 2009; 124: 536-540.
20. Tekbas E, Kara AF, Ariturk Z, et al. Mean platelet vol- ume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment el- evation myocardial infarction. Scand J Clin Lab Invest 2011; 71: 613-619.
21. Braekkan SK, Mathiesen EB, Njolstad I, et al. Mean platelet volume is a risk factor for venous thromboem- bolism - the Tromso study. J Thromb Haemost 2010; 8: 157-162.
22. Kostrubiec M, Labyk A, Pedowska-Wloszek J, Hrynkiewicz-Szymanska A, Pacho S, Jankowski K, Li- chodziejewska B, Pruszczyk P. Mean platelet volume predicts early death in acute pulmonary embolism. Heart 2010;96:460-465.