title: Mean platelet volume in the diagnosis and prognosis of Crimean-Congo hemorrhagic fever.
abstract: BACKGROUND
  Crimean-Congo hemorrhagic fever (CCHF) is a viral tick-borne zoonosis, which is a severe illness, causing hemorrhages in humans. Mean platelet volume (MPV) is used as a surrogate marker of platelet function and has been shown to be a sign of inflammation. The objective of the present study is to examine the association between MPV and CCHF. We also aimed to investigate the association between MPV and coagulopathy markers in the mortality rates and prognosis of patients with CCHF.
  
  
  METHODS
  Ninety-three patients with CCHF were enrolled retrospectively into the study and 15 of them were excluded according to the exclusion criteria. Twenty-five healthy individuals were included as a control group which was age and gender matched with CCHF patients. We compared the levels of MPV between the patient and the control groups. We also compared the coagulopathy markers of fatal CCHF patients (n = 9) with nonfatal cases (n = 69).
  
  
  RESULTS
  Platelet counts were significantly lower in the CCHF group. Levels of international normalized ratio (INR), prothrombin time (PT), and activated partial thromboplastin time (aPTT) were significantly higher in CCHF group (P < .001, <.001, <.001, respectively). A statistically significant increase in MPV was observed in patients with CCHF compared with healthy controls (8.63 ± 1.23 fL vs 7.65 ± 0.42 fL, P < .001). Receiver-operating characteristic curve analysis suggested that the optimum MPV level cutoff points for patients with CCHF was 8.15 fL, with a sensitivity and specificity of 65% and 88%, respectively. The MPV levels were not significantly different between group 2 (nonsurvivor) and group 1 (survivor). However, platelet count, D-dimer, INR, PT, and aPTT were also positively correlated with the mortality rates (P = .008, <.001, <.001, <.001, and <.001, respectively). Multivariable logistic regression model showed an independent correlation between MPV and mortality rate (P < .001).
  
  
  CONCLUSIONS
  In conclusion, MPV may be a beneficial marker in the diagnosis of CCHF, especially in cases with thrombocytopenia, the MPV levels are high. We also conclude that MPV may independently predict the prognosis of patients with CCHF.
authors.affiliation: Department of Gastroenterology, Dışkapı Yıldırım Beyazıt Educational and Research Hospital, Ankara, Turkey. dr_ekiz@yahoo.com
authors.forename: Fuat
authors.initials: F
authors.lastname: Ekiz
authors.forename: Yunus
authors.initials: Y
authors.lastname: Gürbüz
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Basar
authors.forename: Gökhan
authors.initials: G
authors.lastname: Aytekin
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Ekiz
authors.forename: Çiçek Şentürk
authors.initials: ÇŞ
authors.lastname: Sentürk
authors.forename: Bora
authors.initials: B
authors.lastname: Aktas
authors.forename: Baris
authors.initials: B
authors.lastname: Yılmaz
authors.forename: Akif
authors.initials: A
authors.lastname: Altınbaş
authors.forename: Şahin
authors.initials: Ş
authors.lastname: Çoban
authors.forename: İrfan
authors.initials: İ
authors.lastname: Şencan
mesh_terms: D016022:Case-Control Studies; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006479:Hemorrhagic Fever, Crimean / Q000097:blood* / Q000821:virology; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013620:Tajikistan