dc.description.abstract | The aim of this study was to investigate the predictive performance of platelet indices in prognosticating adverse outcomes in this particular patient population.
Materials and Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index () risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints.
Results: MPV, PDW and PLR were 9.9 ± 1.0 fl, 13.5 ± 6.1%, and 14.7 ± 14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events as compared to their counterparts (10.1 ± 1.0 vs 9.9 ± 1.0 fl; p=0.019), PDW and PLR were not different between these two groups (p>0.05). MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95%CI 0.47-0.61). PDW and PLR, respectively, had an AUC of 0.66 (95%CI 0.52-0.80) and 0.61 (95%CI 0.50, 0.72) in predicting in-hospital mortality. The area under the receiver operating curve for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). | en_US |