The relationship between mean platelet volume and mortality in patients in intensive care unit

Abstract

Objectives: In this study we aimed to investigate the mortality rate and the effect of mean platelet volume (MPV) which is a reliable parameter of Glascow Coma Scale (GCS) and thrombocyte function on the mortality of the patients in intensive care unit (ICU). Materials and methods: Data of consecutive 300 patients who interned in ICU were examined retrospectively and 119 patients of those were included in the study. GCS and MPV values, the mortality rate, length of stay in ICU and the mechanic ventilation duration of the patients were calculated. The level and volume of thrombocyte was measured by Beckman Coulter LH 780. Results: The most of our patients were interned from the emergency room (n:116). Fifty-one patiens were transferred to other departments and 19 patients were discharged. The number of the patients who died was 49 and the mortality rate was 41.2%. The mean GCS of survived patients (9.24±1.22) was significantly higher than the mean GCS of dead patients (6.78±1.76) (p0.05). Forty-four of 47 patients who had mechanic ventilation died. Conclusion: MPV values of the survived and dead patients were similar. GCS was found associated with mortality. This study supports that MPV values in admission to ICU don\'t effect the mortality. J Clin Exp Invest 2011; 2 (4): 408-411

Keywords

• Intensive care unit, mortality, mean platelet volume

The relationship between mean platelet volume and mortality in patients in intensive care unit

Öz

Amaç: Yoğun bakım ünitesi (YBÜ) hastalarında mortalite oranını, Glaskow Koma Skoru\'nun (GKS) ve trombosit fonksiyonlarının güvenilir bir parametresi olan ortalama trombosit hacminin (OTH) mortalite üzerine olan etkisini araştırmayı amaçladık. Gereç ve yöntem: YBÜ'ye kabul edilen ardışık 300 hastanın verileri retrospektif olarak incelendi ve 119 hasta çalışmaya alındı. Hastaların başlangıç anındaki GKS, OTH verileri, mortalite oranları, YBÜ\'de kalış süresi ve mekanik ventilasyon süreleri hesaplandı. Trombosit sayı ve hacimleri Beckman Coulter LH 780 kan sayımı cihazı ile ölçüldü. Bulgular: YBÜ\'ye en çok hasta (n:116), hastanemiz acil servisinden kabul edilmişti. Sonuçta 51 hasta başka bir servise devir, 19 hasta ise taburcu edildi. Ölen hastaların sayısı 49 ve mortalite oranı ise %41.2 olarak saptandı. Yaşayan hastaların ortalama GKS değeri (9.24±1.22) ölen hastalarınkinden (6.78±1.76) anlamlı olarak yüksek bulundu (p0.05). Mekanik ventilasyon alan 47 hastanın 44\'ü ölümle sonuçlandı. Tartışma: YBÜ hastalarında ölen ve sağ kalan hastaların kabul OTH\'leri benzer bulundu. GKS mortalite ile ilişkili bulundu. Bu çalışma yoğun bakıma kabul OTH düzeyinin mortaliteye etkisi olmadığını destekler.

Anahtar Kelimeler

• Yoğun bakım ünitesi, mortalite, ortalama trombosit hacmi

Kaynakça

1. Zimmerman JE, Alzola C, Von Rueden KT. The use of benchmarking to identify top performing critical care units: a preliminary assessment of their policies and practices. J Crit Care 2003;18(2):76-86.
2. Le Gall JR, Neumann A, Hemery F, et al. Mortality pre- diction using SAPS II: an update for French intensive care units. Crit Care 2005;9(6):645-52.
3. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fi- brinolysis 1996;7(2):157-61.
4. Sharp DS, Benowitz NL, Bath PM, Martin JF, Beswick AD, Elwood PC. Cigarette smoking sensitizes and desensitizes impedance-measured ADP-induced platelet aggregation in whole blood. Thromb Haemost 1995;74(2):730-5.
5. Tschoepe D, Roesen P, Esser J, et al. Large platelets circulate in an activated state in diabetes mellitus. Semin Thromb Hemost 1991;17(4):433-8.
6. Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, im- paired fasting glucose and non-diabetic subjects. Sin- gapore Med J 2008;49(2):114-6.
7. Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991;338(8780):1409-11.
8. Crawford VL, McNerlan SE, Stout RW. Seasonal changes in platelets, fibrinogen and factor VII in el- derly people. Age Ageing 2003;32(6):661-5.

9. Cameron HA, Phillips R, Ibbotson RM, Carson PH. Platelet size in myocardial infarction. Br Med J (Clin Res Ed) 1983;287(6390):449-51.
10. Erem C, Ersoz HO, Karti SS, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J En- docrinol Invest. 2002; 25(4):345-50.
11. Wedzicha JA, Cotter FE, Empey DW. Platelet size in patients with chronic airflow obstruction with and with- out hypoxaemia. Thorax. 1988;43(1):61-4.
12. Kario K, Matsuo T, Nakao K. Cigarette smoking in- creases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haema- tol 1992;14(4):281-7.
13. Bath PM, Missouris CG, Buckenham T, MacGregor GA. Increased platelet volume and platelet mass in patients with atherosclerotic renal artery stenosis. Clin Sci (Lond) 1994;87(2):253-7.
14. O’Malley T, Langhorne P, Elton RA, Stewart C. Plate- let size in stroke patients. Stroke 1995;26(6):995-9.
15. Glance LG, Osler TM, Dick A. Rating the quality of in- tensive care units: is it a function of the intensive care unit scoring system? Crit Care Med 2002;30(9):1976- 82.
16. Sikka P, Jaafar WM, Bozkanat E, El-Solh AA. A com- parison of severity of illness scoring systems for el- derly patients with severe pneumonia. Intensive Care Med 2000;26(12):1803-10.
17. Bath P, Algert C, Chapman N, Neal B; PROGRESS Collaborative Group. Association of mean plate- let volume with risk of stroke among 3134 individu- als with history of serebrovascular disease. Stroke 2004;35(3):622-6.
18. Güldiken B, Özkan H, Kabayel L. Mean Platelet Volume and Peripheral Blood Count Response in Acute Ischemic Stroke. Trakya Univ Tip Fak Derg 2008;25(2):130-5
19. Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouscchek W. Is Elevated mean platelet volume assosiated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke 2004;35(7):1688-91.
20. Altıay G, Tabakoğlu E, Özdemir L, ve ark. Mortality rates and related factors in respiratory ıntensive care unit patients. Toraks Dergisi 2007;8(2):79-84
21. Uysal N, Gündoğdu N, Börekçi Ş, ve ark. Üçüncü Basamak Merkezde Dahili Yoğun Bakım Hastalarının Prognozu. Yoğun Bakım Derg 2010;1:1-5
22. Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 2002; 287: 345-55.
23. Goldhill DR, Sumner A. Outcome of intensive care patients in a group of British intensive care units. Crit Care Med 1998; 26:1337-45