Platelet indices as a predictor of mortality in critically ill children

Maram A El Hassab, Ahmed AbdelBasset, Abo Elezz, Hossam Hodeib, Yousef Fouad Yousef
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Abstract

In the current study, we aimed to elaborate the utility of platelet indices as biomarkers for predicting critical illness and mortality in critically ill children. Two main groups were included; group I (patient group): Two hundred (200) critically ill children, group II: Two hundred (200) healthy children with comparable age and sex, were enrolled as a control group. All subjects were evaluated clinically and by CBC including platelet indices (MPV, PDW, and PCT). Patient group I were evaluated with SOFA and PRISM scores and subjected to full lab and other radiological and invasive procedures as indicated. Among 200 critically ill patient 33% of them died and 67% survived and were discharged. Interestingly, It was found that Platelet count and PCT were significantly lower in patient group as compared to the control group with p-value (< 0.001). Moreover, the non survivors of patient group showed significantly lower platelet count and PCT values than the survivors in the same group with p-value (< 0.001). In contrast, MPV and PDW were found to be significantly higher in patient group as compared to the control group with p-value (< 0.001), while, the survivors of patient group showed significantly lower MPV and PDW with p-value (< 0.001) Worthy noting that PCT was inversely related to PRISM and SOFA score while, MPV and PDW were directly related to PRISM and SOFA score. PDW was the most sensitive parameter to discriminate between patient and control group with sensitivity 96% while, PCT was the most specific parameter with 99% specificity. In addition, PCT was the most sensitive parameter to predict mortality in patient group with sensitivity 86.57%. Finally, MPV and PDW were the most specific parameters to predict mortality in patient group with specificity 87.88%. In conclusion , this study proved that platelet count and platelet indices are valid predictors for assessment of critical illness and PICU mortality.
预测重症儿童死亡率的血小板指数
在本研究中,我们旨在阐述血小板指数作为生物标志物在预测危重症儿童病情和死亡率方面的效用。研究包括两个主要组别:第一组(患者组):200 名危重症儿童;第二组:200 名无症状儿童:第二组:200 名年龄和性别相当的健康儿童,作为对照组。所有受试者均接受了临床评估和包括血小板指数(MPV、PDW 和 PCT)在内的全血细胞计数评估。第一组患者接受了 SOFA 和 PRISM 评分评估,并根据指示接受了全面的实验室检查和其他放射及侵入性检查。在 200 名重症患者中,33% 的患者死亡,67% 的患者存活并出院。有趣的是,研究发现,与对照组相比,患者组的血小板计数和 PCT 明显较低,P 值(< 0.001)。此外,患者组中未存活者的血小板计数和 PCT 值明显低于同组的存活者,P 值(< 0.001)。值得注意的是,PCT 与 PRISM 和 SOFA 评分成反比,而 MPV 和 PDW 则与 PRISM 和 SOFA 评分直接相关。PDW 是区分患者组和对照组最灵敏的参数,灵敏度为 96%,而 PCT 是最特异的参数,特异度为 99%。此外,PCT 是预测患者组死亡率最灵敏的参数,灵敏度为 86.57%。最后,MPV 和 PDW 是预测患者组死亡率最特异的参数,特异性为 87.88%。总之,这项研究证明,血小板计数和血小板指数是评估危重症和 PICU 死亡率的有效预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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