Can Platelet Count and Mean Platelet Volume and Red Cell Distribution Width Be Used as a Prognostic Factor for Mortality in Intensive Care Unit?

Abstract

Introduction

Critical patients are defined as the patients who have psychological unstability and can cause morbidity and mortality in short time. These patients need to be intensively monitored for organ function like cardiovascular, respiratory and neurology systems The most critical patients are transferred to intensive care to keep close watch. It is not rare that hematological system of critical patient is affected from strong inflammation. These laboratory tests have become very popular because of easy accessibility and lower cost in clinical practice.

The main purpose of this study is to be able to determine platelet count (PLT) and mean platelet volume (MPV) and red cell distribution width (RDW) usage for mortality foresight with admission value at intensive care unit associated with before death value. Secondary purpose is to present a view about clinical use of this blood parameters.

Material and methods

In this study, RDW, MPV and PLT values of the patients in the first intensive cam admission were evaluated and were compared with the last hemogram values before death. Glasgow Coma Score (GCS) and other risk factors for mortality were tried to be determined to show determinants of scoring systems on mortality in patients admitted to ICU.

Results

When compared with ICU entry in all patient groups and laboratory markers prior to exitus, the value of the input RDW was 14.66 +/- 3.08 and the output RDW was 15.94 +/- 9.59. Admission value of MPV was 8.180 +/- 2.09, and before death the value of MPV was 9.199 +/- 2.24. Statistically, it was significantly high (p < 0.001). The MPV values increased in all groups and cerebrovascular disease (CVD), respiratory failure, cardiac causes, head trauma and malignancies were statistically significantly high (p < 0.05). Admission value of PLT was 215.46 +/- 116.8, and before death the value of PLT was 154.73 +/- 101.32. Statistically, it was significantly low (p < 0.001).

Conclusions

The study showed that the difference between PLT, MPV and RDW in relation to the value of the ICU and the pre-death value, and decrease in PLT and increase in MPV and RDW in all patients were statistically significant. We believe that decrease in PLT, increase in MPV and RDW is a prognostic factor for mortality.