Prognostic significance of mean platelet volume to platelet count ratio in pediatric patients with acute kidney injury

Kübra Çeleğen, M. Çeleğen
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Abstract

Background. Mean platelet volume (MPV), which is regarded as a marker of thrombocyte function and activation, is related to increased morbidity and mortality. In critically ill patients, the ratio of MPV to platelets can independently predict adverse outcomes. This study aimed to investigate the prognostic value of the mean platelet volume/platelet count ratio (MPR) for mortality in children with acute kidney injury (AKI). Methods. In this retrospective study, patients hospitalized in the pediatric intensive care unit (PICU) between March 2020 and June 2022 were evaluated. Patients between 1 month and 18 years of age with AKI were enrolled. Clinical and laboratory data were compared between survivors and non-survivors. The MPR ratio was calculated on the first and third days of admission to the intensive care unit. A multiple logistic regression analysis was used to determine the association between MPR and mortality. ROC curves were used for the prediction performance of the logistic regression models and cut-off values of the thrombocyte indices. Results. Sixty-three children with AKI were included in the study. The total mortality rate was 34.9% (n=22). MPR ratios were significantly higher in the non-survivors at admission (p=0.042) and at the 72nd hour (p=0.003). In the multiple logistic regression analysis, thrombocyte counts and MPR72h ratio were found to be independent risk parameters for adverse outcomes in children with AKI. Conclusions. MPR is an inexpensive and practical marker that may predict the outcome of children with AKI.
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急性肾损伤儿科患者平均血小板体积与血小板计数比值的预后意义
背景。血小板平均体积(MPV)被认为是血小板功能和活化的标志,它与发病率和死亡率的增加有关。在重症患者中,MPV 与血小板的比率可独立预测不良预后。本研究旨在探讨平均血小板体积/血小板计数比值(MPR)对急性肾损伤(AKI)患儿死亡率的预后价值。在这项回顾性研究中,对 2020 年 3 月至 2022 年 6 月期间在儿科重症监护室(PICU)住院的患者进行了评估。年龄在1个月至18岁之间的AKI患者均被纳入研究范围。幸存者和非幸存者的临床和实验室数据进行了比较。在入住重症监护室的第一天和第三天计算MPR比率。采用多元逻辑回归分析确定 MPR 与死亡率之间的关系。ROC曲线用于评估逻辑回归模型的预测性能和血小板指数的临界值。研究共纳入63名AKI患儿。总死亡率为 34.9%(22 人)。入院时(P=0.042)和72小时时(P=0.003),非存活者的MPR比率明显较高。在多重逻辑回归分析中发现,血小板计数和 MPR72h 比率是导致 AKI 患儿不良预后的独立风险参数。MPR是一种廉价而实用的标记物,可预测AKI患儿的预后。
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