Does Mean Platelet Volume/Platelet Count Ratio and Red Rlood Cell Distribution Width Predict In-hospital Mortality in Patients Admitted for Acute Exacerbation of Chronic Obstructive Pulmonary Disease?

Authors : Gülseren YİLMAZ, Ziya SALİHOGLU

Pages : 18-25

View : 22 | Download : 15

Publication Date : 2019-06-30

Article Type : Research Paper

Abstract :Background: The critical role of inflammation in increasing the frequency and the severity of the exacerbations has been demonstrated previously. Some previous research indicates that simple blood tests of inflammation such as neutrophil–lymphocyte ratio insert ignore into journalissuearticles values(NLR); and platelet–lymphocyte ratio insert ignore into journalissuearticles values(PLR); performed at admission might predict the severity of exacerbation and resultant outcomes. The purpose of the present study was to investigate the role of MPV/PLT and other parameters of complete blood count insert ignore into journalissuearticles values(CBC); in predicting in-hospital mortality in patients with AECOPD. Materials and Methods: 171 patients admitted to the intensive care unit of our institute -a tertiary center- with acute exacerbation of COPD between May 2014 and August 2018 were retrospectively recruited in the study. Demographic and clinical data including age, gender, accompanying chronic diseases, spirometric data, and pretreatment laboratory test results were extracted from the institutional digital database. The study population was divided into two groups according to the development of in-hospital mortality as survivors or non-survivors. Results:   Thirty-six subjects died during the in-hospital course insert ignore into journalissuearticles values(non-survivors); and 135 survived insert ignore into journalissuearticles values(survivors);. Non-survivors had higher C-reactive protein insert ignore into journalissuearticles values(p<0.001);, NLR insert ignore into journalissuearticles values(p=0.037);, PLR insert ignore into journalissuearticles values(p=0.021);, mean platelet volume insert ignore into journalissuearticles values(p<0.001);, and MPV/PLT insert ignore into journalissuearticles values(p=0.004); compared to survivors. Admission pH was significantly lower in no-survivors that survivors p<0.001. Logistic regression analysis revealed that among several variables, GOLD stage > 2 insert ignore into journalissuearticles values(OR: 2.222, 95 % CI: 1.196-4.128, p=0.012);, admission CRP insert ignore into journalissuearticles values(OR: 1.158);, RDW insert ignore into journalissuearticles values(OR: 2.327);, pH insert ignore into journalissuearticles values(OR: 0.002);, NLR insert ignore into journalissuearticles values(OR: 1.902);, and MPV/PLT insert ignore into journalissuearticles values(OR: OR: 1.332); were independent predictors of in-hospital mortality in patients with AECOPD. ROC curve analysis indicated a cut of value of 43.57 insert ignore into journalissuearticles values(sensitivity 67%, specifity 66%); for CRP, 15.4 % for RDW insert ignore into journalissuearticles values(sensitivity 74 %, specifity 75 %);, 3.18 for NLR insert ignore into journalissuearticles values(sensitivity 71 %, specifity 72 %);, and 4.45 for MPV/PLT insert ignore into journalissuearticles values(sensitivity 67 %, specifity 68%); to predict in hospital-mortality in patients with AECOPD Conclusions: MPV/PLT, as an emerging indicator of preexisting inflammation, and RDW indicating intermittent hypoxemia, independently predict in-hospital mortality in patients with AECOPD. Implementation of MPV/PLT and RDW in addition to GOLD stage, pH, NLR and CRP might be useful in identifying patients who will require advanced support during admission for AECOPD.  
Keywords : Acute exacerbation of chronic obstructive pulmonary disease, in hospital mortality, neutrophillymphocyte ratio, plateletlymphocyte ratio, red blood cell distribution width