Mean platelet volume dynamics as a prognostic indicator in pediatric surgical intensive care unit: a descriptive observational study

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Abstract

Background
Platelet size and activity have a close correlation. The mean platelet volume (MPV) is related to the disease severity and prognosis, especially in critically ill patients.
Objective
To study the relation between MPV changes and postoperative morbidities and mortality in pediatric surgical intensive care unit (PSICU).
Methods and material
We enrolled in this descriptive observational study one hundred PSICU children aged from 1 month to 18 years and stayed for > 48 h for peri-operative or post-trauma management. The 1ry outcome was the association between percentage change in MPV (ΔMPV) value and mortality. We recorded MPV, ΔMPV, and platelet count as a baseline, at day 0, 1st, 2nd, 3rd, 5th, and 7th days and then once weekly until patients were discharged, died, or reached a maximum of 90 days in ICU stay.
Statistical analysis used
We used statistical package for the social science (SPSS) version 22. Non-parametric Mann-Whitney test made comparisons between quantitative variables. Repeated measures analysis of variance (ANOVA), non-parametric Friedman, and Wilcoxon signed-rank tests made the comparison within the same patients. We used receiver operating characteristic (ROC) curves for the detection of sensitivity and specificity.
Results
Patients who developed ICU complications showed higher ΔMPV compared with non-complicated cases, and this was statistically significant on days 2, 3, 5, and 7 of ICU stay. ROC curve analysis showed a sensitivity of 57.2% and 73% on days 2 and 3 and a specificity of 76.6% and 71% on days 2 and 3, respectively.
Conclusions
MPV dynamics have a prognostic role and worth a value in predicting several complications in PSICU.

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