Duran Mehmet, Uludağ Öznur
Anesthesiology and Reanimation, Adiyaman University Education and Research Hospital, Adiyaman, TUR.
Anesthesiology and Reanimation, Adıyaman University Faculty of Medicine, Adıyaman, TUR.
Cureus. 2020 Nov 22;12(11):e11630. doi: 10.7759/cureus.11630.
Introduction Critical patients are those patients who have psychological unstability that can cause morbidity and mortality in a short period of time. These patients need to be intensively monitored for organ function like cardiovascular, respiratory and neurological system. The most critical patients are transferred to intensive care unit (ICU) for close watch. It is not rare that hematological system of critical patient is affected from strong inflammation. The main purpose of this study is to be able to determine platelet count (PLT), mean platelet volume (MPV) and red cell distribution width (RDW) admission value to predict mortality in ICU. Secondary purpose is to present a view about clinical use of these blood parameters. Material and methods In this study, RDW, MPV and PLT values of the patients in the first intensive care 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 values in the ICU and values before death, 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.
引言
重症患者是指那些心理状态不稳定，可能在短时间内导致发病和死亡的患者。这些患者需要对心血管、呼吸和神经系统等器官功能进行密切监测。最危急的患者会被转至重症监护病房（ICU）进行密切观察。重症患者的血液系统受强烈炎症影响的情况并不罕见。本研究的主要目的是能够确定血小板计数（PLT）、平均血小板体积（MPV）和红细胞分布宽度（RDW）的入院值，以预测ICU患者的死亡率。次要目的是就这些血液参数的临床应用提出一种观点。
材料与方法
在本研究中，对首次入住重症监护病房患者的RDW、MPV和PLT值进行了评估，并与死亡前的最后一次血常规值进行了比较。试图确定格拉斯哥昏迷评分（GCS）和其他死亡风险因素，以显示评分系统对入住ICU患者死亡率的决定因素。
结果
与所有患者组的ICU入院时相比以及与死亡前的实验室指标相比，入院时RDW的值为14.66±3.08，死亡时RDW的值为15.94±9.59。MPV的入院值为8.180±2.09，死亡前MPV的值为9.199±2.24。在统计学上，其显著升高（p<0.001）。所有组的MPV值均升高，且脑血管疾病（CVD）、呼吸衰竭、心脏病因、头部外伤和恶性肿瘤在统计学上显著升高（p<0.05）。PLT的入院值为215.46±116.8，死亡前PLT的值为154.73±101.32。在统计学上，其显著降低（p<0.001）。
结论
该研究表明，ICU中PLT、MPV和RDW值与死亡前的值之间存在差异，且所有患者的PLT降低、MPV和RDW升高在统计学上具有显著性。我们认为，PLT降低、MPV和RDW升高是死亡率的一个预后因素。
