An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock

Chan Ho Kim, Seung Jun Kim, Mi Jung Lee, Young Eun Kwon, Yung Ly Kim, Kyoung Sook Park, Han Jak Ryu, Jung Tak Park, SeungHyeok Han, TaeHyun Yoo, Shin-Wook Kang, Hyung Jung Oh

Research output: Contribution to journalArticle

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Abstract

Introduction: Mean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock. Methods: We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis. Results: Thirty-five (10.1%) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44;95% confidence interval, 1.01-2.06; P = 0.044). Conclusions: An increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.

Original languageEnglish
Article numbere0119437
JournalPloS one
Volume10
Issue number3
DOIs
Publication statusPublished - 2015 Mar 5

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Mean Platelet Volume
septic shock
sepsis (infection)
Septic Shock
Platelets
Sepsis
Mortality
Survivors
Hospital Emergency Service
Blood Platelets
Hazards
Resuscitation
Proportional Hazards Models
multivariate analysis
confidence interval
Linear Models
Hospitalization
Anti-Inflammatory Agents
risk factors
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kim, C. H., Kim, S. J., Lee, M. J., Kwon, Y. E., Kim, Y. L., Park, K. S., ... Oh, H. J. (2015). An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PloS one, 10(3), [e0119437]. https://doi.org/10.1371/journal.pone.0119437
Kim, Chan Ho ; Kim, Seung Jun ; Lee, Mi Jung ; Kwon, Young Eun ; Kim, Yung Ly ; Park, Kyoung Sook ; Ryu, Han Jak ; Park, Jung Tak ; Han, SeungHyeok ; Yoo, TaeHyun ; Kang, Shin-Wook ; Oh, Hyung Jung. / An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. In: PloS one. 2015 ; Vol. 10, No. 3.
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abstract = "Introduction: Mean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock. Methods: We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis. Results: Thirty-five (10.1{\%}) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44;95{\%} confidence interval, 1.01-2.06; P = 0.044). Conclusions: An increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.",
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An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. / Kim, Chan Ho; Kim, Seung Jun; Lee, Mi Jung; Kwon, Young Eun; Kim, Yung Ly; Park, Kyoung Sook; Ryu, Han Jak; Park, Jung Tak; Han, SeungHyeok; Yoo, TaeHyun; Kang, Shin-Wook; Oh, Hyung Jung.

In: PloS one, Vol. 10, No. 3, e0119437, 05.03.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock

AU - Kim, Chan Ho

AU - Kim, Seung Jun

AU - Lee, Mi Jung

AU - Kwon, Young Eun

AU - Kim, Yung Ly

AU - Park, Kyoung Sook

AU - Ryu, Han Jak

AU - Park, Jung Tak

AU - Han, SeungHyeok

AU - Yoo, TaeHyun

AU - Kang, Shin-Wook

AU - Oh, Hyung Jung

PY - 2015/3/5

Y1 - 2015/3/5

N2 - Introduction: Mean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock. Methods: We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis. Results: Thirty-five (10.1%) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44;95% confidence interval, 1.01-2.06; P = 0.044). Conclusions: An increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.

AB - Introduction: Mean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock. Methods: We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis. Results: Thirty-five (10.1%) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44;95% confidence interval, 1.01-2.06; P = 0.044). Conclusions: An increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.

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