PLATELET INDEXES FOR BACTERIAL SEPSIS SEVERITY ASSESSMENT
DOI:
https://doi.org/10.24293/ijcpml.v24i3.1327Keywords:
Sepsis, procalcitonin, platelet indexesAbstract
Sepsis is an infection-induced syndrome, mostly caused by bacteria, of organ dysfunctions caused by host response dysregulations. One of the simplest sepsis-indicator is platelet. This study aimed to determine whether platelet indexes i.e. Immature Platelet Fraction (IPF), platelet count, Mean Platelet Volume (MPV), plateletcrit (Pct), and Platelet Distribution Width (PDW), could assess sepsis severity by procalcitonin (PCT). This cross-sectional study was conducted at the Department of Clinical Pathology Adam Malik Hospital Medan from October to December 2016. Patients who had their full blood count examined with increased PCT ≥0.05 ng/mL were included. Sixty four of 71 patients with increased PCT were included in this study and separated into 3 groups based on their PCT levels (I = ≥0.05 – <2 ng/mL; II = ≥2 - <10 ng/mL; III = ≥10 ng/mL). Platelet count and plateletcrit showed a significant decrease when group I or II were compared to group III (p <0.05), but when the group I was compared to the group II there was no significance. On the other hand, the other platelet indexes showed no significance amongst the groups. Higher sepsis severity based on PCT affected more of the platelet number, as the result of platelet destructions caused by pro-inflammatory cytokines and endotoxins.
Downloads
References
Singer M, Deutschman CS, Seymour CW, Shankar MH, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3), JAMA, 2016; 315(8): 801-810.
Munford RS. Severe sepsis and sepsis shock. In DL. Kasper & AS. Fauci, eds. Harrison's infectious diseases. 17th Ed., The McGraw-Hill Companies Inc., 2010; 162-73.
Bataar O, Lundeg G, Tsenddorj G, Jochberger S, Grander W, et al. World Health Organization, 2010; http://www.who.int/bulletin/volumes/88/11/10-077073/en/ (Accessed on 10 Mei 2016).
Pradipta IS, Sodik DC, Lestari K, Parwati I, Halimah E, et al. Antibiotic resistance in sepsis patients: Evaluation and recommendation of antibiotic use, North American Journal of Medical Sciences; 2013; 5(6): 344–352.
Medical Record RSUP Haji Adam Malik, 2015.
Camacho CH, Losa J. Biomarkers for sepsis, Critical Reviews in Clinical Laboratory Sciences, 2014; 50(1): 23-36.
Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology. 7th Ed., Philadelphia, Saunders Elsevier, 2012; 43-57
Rhodes A, Evans LA, Alhazzani W, Levy MM, Antonelli M, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2016, Intensive Care Medicine, 2016; 43: 304–377.
Laukemann S, Kasper N, Kulkarni P, Steiner D, Rast AC, et al. Can we reduce negative blood cultures with clinical scores and blood markers? Results from an observational cohort study, Medicine Journal, 2015; 94(49): 1-10.
Jin M, Khan AI. Procalcitonin: Uses in the clinical laboratory for the diagnosis of sepsis, Laboratory Medicine Journal, 2010; 41(3): 173-177.
Karlsson S, Heikkinen M, Pettila V, Alila S, Vaisanen S, et al. Predictive value of procalcitonin decrease in patients with severe sepsis: A prospective observational study, Journal of Critical Care, 2010; 14(6): 1-10.
NICE. Diagnosis and monitoring of sepsis: procalcitonin testing (ADVIA Centaur BRAHMS PCT assay, BRAHMS PCT sensitive Kryptor assay, elecsys BRAHMS PCT assay, LIAISON BRAHMS PCT assay and VIDAS BRAHMS PCT assay), National Institute for Health and Care Excellence, 2014; 1-20.
Venkata C, Kashyap R, Farmer J, Afessa B. Thrombocytopenia in adult patients with sepsis: incidence, risk factors and its association with clinical outcome, Journal of Intensive Care, 2013; 1(1): 1-9.
Saracco P, Vitale P, Scolfaro C, Pollio B, Pagliarino M, Timeus F. The coagulopathy in sepsis: Significance and implications for treatment, Pediatric Reports, 2011; 3(4): 119-121
Yilmaz T, Yilmaz A. Relationship between altered platelet morphological parameters, and retinopathy in patients with type 2 diabetes mellitus, Journal of Ophthalmology, 2016; 2016(2016): 1-5.
Gao Y, Li Y, Yu X, Guo S, Ji X, et al. The Impact of various platelet indices. As prognostic markers of septic shock, Plos One, 2014; 9(8): 1-7.
Park SH, Ha SO, Cho YU, Park CJ, Jang S, Hong SB. Immature platelet fraction in septic patients: Clinical relevance of immature platelet fraction is limited to the sensitive and accurate discrimination of septic patients from non-septic patients, not to the discrimination of sepsis severity, Annual Laboratory Medicine, 2016; 36(1): 1-8.
Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices, African Health Sciences, 2013; 13(2): 333–338.
Sharma R, Vijayakumar M. Procalcitonin for improved assessment and an answer to sepsis dilemma in critically ill - a myth, a hype, or a reality?, Nitte University Journal of Health Science, 2014; 4(1): 57-65.
Hazrati E, Tavakoli M, Alizadeh H, Mahdaviani B, Noorifard M. The correlation between serum procalcitonin and sequential organ failure assessment score in severe sepsis patients, Journal of Current Research in Science, 2016; S(1): 135-139.
Akpinar I, Sayin MR, Gursoy YC, Aktop Z, Karabag T, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon, Journal of Cardiology, 2014; 63(2): 112-8.
Cho SY, Yang JJ, Nam YS, Suh JT, Park TS, Lee HJ. Mean platelet volume in patients with increased procalcitonin level, Platelets, 2013; 24(3): 246-247.
Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: A simple, practical and specific marker of activation of coagulation, Hippokratia, 2010; 14(1): 28–32.
Hubert RME, Rodrigues MV, Andreguetto BD, Santos TM, de Fatima Pereira Gilberti M, et al. Association of the immature platelet fraction with sepsis diagnosis and severity, Scientific Reports, 2015; 1-6.
De Blasi RA, Cardelli P, Constante A, Sandri M, Mercieri M, Arcioni R. Immature platelet fraction in predicting sepsis in critically ill patients, Intensive Care Medicine, 2013; 39(4): 636-643.
Watanabe Y, Oikawa N, Hariu M, Fuke R, Seki M. Ability of procalcitonin to diagnose bacterial infection and bacteria types compared with blood culture findings, International Journal of General Medicine, 2016; 2016(9): 325–331.
