Golwala Zainab Mohammedi, Shah Hardik, Gupta Neeraj, Sreenivas V, Puliyel Jacob M
Department of Pediatrics and Neonatology, St. Stephens Hospital, New Delhi.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi.
Afr Health Sci. 2016 Jun;16(2):356-62. doi: 10.4314/ahs.v16i2.3.
Thrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital.
To determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children.
Children who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality.
Forty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV × PDW/Platelet count × PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69-10.99), 3.86 (95% CI, 1.53-9.75), 3.45 (95% CI, 1.38-8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45.
The MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately.
血小板减少已被证明可预测死亡率。我们推测血小板指标可能是更有用的预后指标。我们的研究对象为我院收治的1个月至14岁儿童。
确定血小板计数、血小板压积（PCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）及其比值是否可预测住院儿童的死亡率。
以住院期间死亡的儿童为病例组。对照组为同期入院的年龄匹配儿童。入院后的第一份血样用于分析。采用受试者工作特征（ROC）曲线确定所测变量及研究比值的最佳阈值。进行多元回归分析以确定死亡率的独立预测因素。
共研究了40例病例和40例对照。存活儿童与死亡儿童相比，血小板计数、PCT以及MPV/血小板计数、MPV/PCT、PDW/血小板计数、PDW/PCT和MPV×PDW/血小板计数×PCT的比值存在显著差异。多元回归分析显示，MPV/PCT比值、PDW/血小板计数和MPV/血小板计数是死亡率的危险因素，比值比分别为4.31（95%CI，1.69 - 10.99）、3.86（95%CI，1.53 - 9.75）、3.45（95%CI，1.38 - 8.64）。67%死亡患者的MPV/PCT比值高于41.8，PDW/血小板计数高于3.86。65%死亡患者的MPV/血小板计数高于3.45。
在本病例对照研究中，入院后第一份样本中的MPV/PCT、PDW/血小板计数和MPV/血小板计数是死亡率的预测指标，可准确预测65%至67%的死亡情况。
