Association of mean platelet volume and platelet - lymphocyte ratio with in -hospital outcome of acute pulmonary embolism

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).