Prognostic significance of critical patients' platelet indexes in mixed type critical care unit/Karma Yogun Bakimda Takip Edilen Kritik Hastalarda Platelet Indekslerinin Prognostik Degeri

• Published in: Yogu︣n bakim dergisi Vol. 10; no. 1; p. 13
• Main Authors: Efe, Serdar, Asker, Ismail, Inal, Volkan
• Format: Journal Article
• Language: English
• Published: AVES 01.04.2019
• Subjects: Biological markers; Computer industry; Health aspects; Intelligence gathering; Medical research; Mortality; Rutin; United States; United States
• ISSN: 1309-1689; 1309-6222
• DOI: 10.33381/dcbybd.2019.1877

Introduction: Thrombocyte indexes (TIN) are biological markers of thrombocyte morphology and function. In critical patients, few studies evaluated TIN relation with disease severity and prognosis. Aim: In this study, we objected to evaluate TIN as a routine feasible parameter at respect of clinical significance to predicting mortality, even though thrombocyte count and functions were prone to alter by variable conditions of critical care unit patients. Materials and methods: Data of 314 patients those with objected parameters out of 347 retrospectively evaluated for TIN relation with clinical surveillance and demographics, in a ten bed capacity mixed-type tertiary CCU in between Jan 1st-31st Dec 2016. Results: Patients', 194 male (62%), mean age was 62.7 [+ or -] 16.9 (19-86) and APACHE II score was 18.9 [+ or -] 8.5, mean length of stay (LOS) was 9.1 (1-182) days and with 43% mortality. The mean thrombocyte volume (MPV) and dispersion width (PDW) indexes were both correlated each other and positively with disease severity, on the other hand negatively with thrombocyte count. The higher plateletcrit (PCT) levels otherwise lower MPV and PDW were found in males, and also showed relatively lower mortality rates (37.6%<44.1%) (p<0.01). Increrased PDW levels and lower thrombocyte counts were related to higher mortality, in addition to this, PCT<0.17 levels showed 2x higher mortality risk compared to PCT>0.32. Both PDW/PLT and PDW/ PCT ratios related to mortality too (p<0.001, p<0.001), otherwise with relatively lower coefficients (r: 0,11, r: 0,10). Conclusion: TIN in mixed type CCUs was assumed as PDW and PCT could be included to disease severity scoring system prognostic biomarkers, like thrombocyte counts. Keywords: Platelet indexes, mean platelet volume, platelet dispersion width, platelecrit Giris: Trombosit indeksleri (TIN), trombositlerin morfolojisi ve fonksiyonlari hakkinda bilgi veren biyolojik belirteclerdir. Kritik hastalarda TIN'leri hastalik siddet ve prognozuyla iliskilendiren az sayida calisma vardir. Amac: Calismamizda trombosit sayi ve fonksiyonlarini etkileyebilecek pek cok etkenin maruziyeti altinda olan YBU hastalarinda, rutin olarak calisilan trombosit indekslerinin klinik onemini ve mortaliteyi ongormedeki basarisini degerlendirmeyi amacladik. Gerec ve yontemler: 01 Ocak 2016- 31 Aralik 2016 tarihleri arasinda 10 yatakli ucuncu basamak karma YBU'de takip edilen 347 hastadan TIN'leri olculebilen 314 hastanin demografik ozellikleri ve klinik takip verileri geriye yonelik olarak incelendi. Bulgular: Hastalarin 194'u (%62) erkek, yas ortalamasi 62.7 [+ or -] 16.9 (19-86), APACHE II hastalik siddet skor ortalamasi 18.9 [+ or -] 8.5, ortalama yatis suresi (OYS) 9.1 (1-182) gun ve mortalite %43 saptanmistir. Ortalama trombosit hacmi (MPV) ve trombosit dagilim genisligi (PDW) indekslerinin birbirleriyle korele oldugu; bununla birlikte hastalik siddeti ile pozitif, trombosit sayisi ile negatif korelasyon gosterdikleri tespit edilmistir. Erkek cinsiyette MPV ve PDW dusuk, plateletcrit (PCT) ise yuksek saptanmistir, bununla birlikte mortalite orani nispeten dusuk gerceklesmistir (%37.6<%44.1) (p<0.01). Genel hasta populasyonuna bakildiginda ise PDW artisi ve trombosit dusuklugunun mortalite artisi ile iliskili oldugu, PCT degeri 0.17'nin altinda oldugunda, 0.32'nin uzerinde olanlara gore mortalite riskinde iki kat artis oldugu tespit edilmistir. Ayrica PDW/ PLT ve PDW/PCT oranlarinin her ikisinin de mortaliteyle korele (p<0.001, p<0.001) oldugu ancak ozgulluk ve duyarliliklarinin yeterli duzeyde olmadigi (r:0,11, r:0,10) gozlenmistir. Sonuc: Trombosit indekslerinden PDW ve PCT'nin karma yogun bakim unitelerinde, trombosit duzeyi gibi hastalik siddetini tanimlayan ve skorlama sistemlerine dahil edilebilecek, prognostik biyo-belirtecler oldugu kanaatine varildi. Anahtar kelimeler: Trombosit indeksleri, ortalama trombosit hacmi, trombosit dagilim genisligi, plateletcrit.