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Updated: Jan 5, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Kinetics of mean platelet volume predicts mortality in patients with septic shock
Fanny Vardon-Bounes1,2, Marie-Pierre Gratacap2, Samuel Groyer1
1Anesthesiology and Critical Care Unit, Toulouse University Hospital, Toulouse, France.
Introduction:
Thrombocytopenia is well recognized as a poor prognosis sign associated with increased mortality and prolonged Intensive Care Unit (ICU) stay, particularly in septic patients. Mean platelet volume (MPV) could represent a relevant predictive marker of mortality. Here we investigated whether MPV kinetics during the first 15 days after hospital admission has a potential prognostic value for clinical outcome in septic shock.
Methods:
We performed a retrospectively analysis of a cohort of 301 septic patients admitted in ICU. Three-month mortality was the primary endpoint. The prognostic value of the covariates of interest was ascertained by multidimensional analysis. We proposed a classification and regression trees analysis to predict survival probability.
Results:
MPV kinetics was significantly different between 90-day survivors and non-survivors when followed during 15 days (except on day 3). 10-day MPV >11.6fL was an independent predictive factor of 90-day mortality (Hazard Ratio (HR) 3.796, 95% Confidence Interval (CI) [1.96-7.35], p = 0.0001) in multivariate analysis. Base excess on day 4 <1.9mmol/L was also a predictive factor of mortality (HR 2.972, 95%CI [1.38-6.40], p = 0.0054.
Conclusion:
MPV increase during the first 15 days after ICU admission in non-survivors was observed during septic shock and 10-day MPV >11.6fL was an independent predictive factor of 90-day mortality. This could be explained by the emergent response to acute platelet loss during septic shock, leading to megakaryocyte rupture to produce new but potentially immature platelets in the circulation. Therefore, continuous monitoring of MPV may be a useful parameter to stratify mortality risk in septic shock.
Insights
Mean platelet volume (MPV) changes over 15 days can predict mortality in septic shock patients. A higher MPV on day 10 indicates increased 90-day mortality risk, aiding clinical outcome prediction.
Area of Science:
- Critical Care Medicine
- Hematology
- Clinical Pathology
Background:
- Thrombocytopenia is a known poor prognostic indicator in septic patients, associated with higher mortality and longer ICU stays.
- Mean platelet volume (MPV) is a potential predictive marker for mortality.
- Investigating MPV kinetics may offer prognostic value in septic shock.
Purpose of the Study:
- To evaluate the prognostic value of MPV kinetics during the first 15 days post-hospital admission for clinical outcomes in septic shock patients.
- To determine if MPV trends can predict 90-day mortality in this cohort.
Main Methods:
- Retrospective analysis of 301 septic patients admitted to the ICU.
- Three-month mortality was the primary endpoint.
- Multidimensional analysis and classification and regression trees were used to assess prognostic value and predict survival probability.
Main Results:
- MPV kinetics differed significantly between 90-day survivors and non-survivors over 15 days (except day 3).
- An MPV >11.6 fL on day 10 independently predicted 90-day mortality (HR 3.796, p=0.0001).
- Base excess <1.9 mmol/L on day 4 also predicted mortality (HR 2.972, p=0.0054).
Conclusions:
- MPV increase during the first 15 days post-ICU admission was observed in non-survivors of septic shock.
- Day 10 MPV >11.6 fL is an independent predictor of 90-day mortality.
- Continuous MPV monitoring could aid in stratifying mortality risk for septic shock patients.
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