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The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis


Affiliations
1 Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2 Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
 

Background: An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients. Objective: We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients. Methods: We did electronic search in Medline, Scopus, and Embase up to November 2015. Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38; p = 0.112). However, after small sample studies were excluded in sensitivity analysis, the poolingmean difference ofMPVwas 0.32 (95% CI: 0.04, 0.60; p = 0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%. Conclusions: Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values ofMPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.
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  • The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis

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Authors

Pattraporn Tajarernmuang
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Arintaya Phrommintikul
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Atikun Limsukon
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Chaicharn Pothirat
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Kaweesak Chittawatanarat
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

Abstract


Background: An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients. Objective: We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients. Methods: We did electronic search in Medline, Scopus, and Embase up to November 2015. Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38; p = 0.112). However, after small sample studies were excluded in sensitivity analysis, the poolingmean difference ofMPVwas 0.32 (95% CI: 0.04, 0.60; p = 0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%. Conclusions: Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values ofMPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.