ASSOCIATION OF MEAN PLATELET VOLUME AND PLATELET HISTOGRAM CHANGES WITH 28-DAY MORTALITY IN PATIENTS WITH SEVERE SEPSIS: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Platelet activation and consumption are important components of the pathophysiology of severe sepsis. Mean platelet volume (MPV), a routinely available hematological parameter reflecting platelet size, may have potential value in assessing disease severity and prognosis. This prospective observational study evaluated the association of increased MPV and concurrent platelet histogram changes with 28-day mortality among 150 patients with severe sepsis admitted to the Intensive Medical Care Unit of tertiary care Hospital, over a period of 2 years. Venous blood samples were collected within 12 h of presentation and processed within 4-6 h of collection. Platelet count, MPV, and platelet histograms were analyzed using a three-part automated hematology analyzer (Sysmex XP-100). Clinical outcome was assessed as survival or mortality at 28 days. Of 150 patients, 80 survived and 70 died, corresponding to a 28-day mortality of 46.7%. Mean platelet count was significantly lower among non-survivors than survivors (175.357 ± 129.771 × 10³/µL vs 242.225 ± 127.365 × 10³/µL; P < 0.001), whereas mean MPV was significantly higher among non-survivors (10.997 ± 1.313 fL vs 10.065 ± 0.995 fL; P < 0.001). Platelet histogram changes were identified in 14 patients, including 10 non-survivors and four survivors, but were not significantly associated with mortality (P = 0.09). Higher MPV and lower platelet count were associated with 28-day mortality, whereas platelet histogram changes were not. MPV may have potential value as a complementary hematological parameter for mortality risk assessment in severe sepsis; however, its independent prognostic value requires further investigation.