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Published on: January 31, 2018
Changes in the mean platelet volume levels after bloodstream infection have prognostic value
Takatoshi Kitazawa1, Yusuke Yoshino, Keita Tatsuno
1Department of Infectious Diseases, Graduate School of Medicine, the University of Tokyo, Japan. tkitazaw-tky@umin.ac.jp
Objective:
Thrombocytopenia is frequently observed during bloodstream infection (BSI); however, little is known about the trends in platelet size during BSI. The aim of this study was to investigate trends in platelet indices during BSI and to determine the relationship between the mean platelet volume (MPV) levels and the prognosis of BSI patients.
Methods:
We conducted a four-year retrospective study to assess the trends in the platelet indices and the clinical features of BSI. We enrolled 350 patients with positive blood cultures and measured the platelet indices during five periods: 30 to seven days before onset (1st period); within one day of onset (2nd period); three to five days after onset (3rd period); seven to 10 days after onset (4th period); and 14 to 19 days after onset (5th period). The end point was defined as 30-day mortality.
Results:
Among the BSI patients, the average platelet count decreased during BSI (29.4 *10(9)/L to 24.0 *10(9)/L, p<0.001), while the average MPV level increased (7.33 fL to 7.89 fL, p<0.001). The degree of MPV elevation in the nonsurvivors (n=25) was lower than that observed in the survivors (n=325) between the 1st and 2nd periods (0.00 fL vs. 0.35 fL, p=0.006), whereas between the 2nd and 3rd periods, the degree of MPV elevation in the nonsurvivors was higher than that observed in the survivors (0.74 fL vs. 0.19 fL, p=0.03). MPV elevation after BSI was identified to be a negative prognostic factor for BSI (odds ratio: 1.82; 95% confidence interval: 1.00-3.32; p=0.027).
Conclusion:
Changes in the MPV levels after BSI may therefore be a useful prognostic marker for BSI.
Insights
Mean platelet volume (MPV) increases during bloodstream infections (BSI). Elevated MPV after BSI is a negative prognostic factor, indicating poorer outcomes for patients with BSI.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Thrombocytopenia is common in bloodstream infections (BSI).
- Trends in platelet size (mean platelet volume, MPV) during BSI are not well understood.
- Investigating MPV changes may offer insights into BSI pathophysiology and patient prognosis.
Purpose of the Study:
- To examine trends in platelet indices, specifically MPV, during BSI.
- To determine the association between MPV levels and the prognosis of patients with BSI.
Main Methods:
- A four-year retrospective study analyzed 350 patients with positive blood cultures.
- Platelet indices were measured during five distinct periods relative to BSI onset.
- Thirty-day mortality was used as the primary endpoint to assess prognosis.
Main Results:
- Platelet counts decreased, while mean platelet volume (MPV) significantly increased during BSI.
- MPV elevation patterns differed between survivors and non-survivors.
- Elevated MPV post-BSI was identified as a negative prognostic factor (OR: 1.82, p=0.027).
Conclusions:
- Mean platelet volume (MPV) exhibits distinct trends during bloodstream infections (BSI).
- MPV changes following BSI can serve as a valuable prognostic marker.
- Monitoring MPV may aid in predicting outcomes for BSI patients.
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