Therapeutics and Clinical Risk Management (Nov 2018)

Complex calculation or quick glance? Mean platelet volume – new predictive marker for pulmonary embolism

  • Lipinska A,
  • Ledakowicz-Polak A,
  • Krauza G,
  • Przybylak K,
  • Zielinska M

Journal volume & issue
Vol. Volume 14
pp. 2221 – 2228

Abstract

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Anna Lipinska, Anna Ledakowicz-Polak, Grzegorz Krauza, Katarzyna Przybylak, Marzenna Zielinska Intensive Cardiac Therapy Clinic, Department of Interventional Cardiology and Electrocardiology, Central Clinical Hospital, Lodz, Poland Background: Wells and Geneva scores are widely used in the assessment of pretest probability of pulmonary embolism (PE). Objective: The objective of this study was to examine the hypothesis that mean platelet volume (MPV) may better predict PE than the clinical prediction rules. Methods: A study was performed among patients with PE. Baseline characteristics and complete blood counts including MPV were prospectively recorded upon admission. To assess clinical probability in patients with PE risk, we used Wells and Geneva scores. Results: Data records of 136 patients (males: 44%) with median age of 66 years (interquartile range [IQR] 57.5–78.0) diagnosed with PE at the Intensive Cardiac Therapy Clinic in Lodz (Poland) were analyzed. Baseline characteristics indicate that patients suffered from arterial hypertension (65%), obesity (32%), and diabetes mellitus (24%). Furthermore, they reported active smoking (21%), prolonged immobilization (20%), major surgery (21%), pregnancy (4%), and oral contraceptives (9%). Patients presented with various symptoms. The MPV, plateletcrit, and D-dimer values on admission were respectively as follows: 10.71 (IQR 3.29–13.67), 0.2 (IQR 0.15–0.24), and 9.23 (IQR 8.5–9.85). The study revealed that Wells score correlated significantly with an elevated MPV value (P<0.05) per contra to Geneva score (P>0.05). According to our results, there is a lack of coherence between Wells and Geneva scores (P>0.05). Finally, we determined that the optimum MPV level cutoff point for PE on admission with reference to the original Wells score is 9.6 fL. Conclusion: MPV may be considered useful as an adjunctive or independent predictive marker for PE used in lieu of clinical prediction rules. Keywords: pulmonary embolism, mean platelet volume, Wells score, Geneva score

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