title: Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia.
abstract: OBJECTIVE
  This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, >65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP).
  
  
  METHODS
  This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality.
  
  
  RESULTS
  A total of 174 patients (mean age, 66.7 ± 15.8 years; 66.1% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 16.1%. A significant and inverse correlation between MPV and CURB-65 score was found (R = -.58, P < .001). We determined that the optimal MPV cutoff for predicting 28-day mortality at the time of ED admission was 8.55 fL, with a 75.0% sensitivity and a 75.3% specificity. For the prediction of 28-day mortality, the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI], 0.740-0.898; P < .001) when the CURB-65 score was used alone, whereas it increased to 0.895 (95% CI, 0.819-0.936; P < .001) with the addition of MPV to the score.
  
  
  CONCLUSIONS
  Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality.
authors: Celal Bayar University, Faculty of Medicine, Department of Emergency Medicine, Manisa, Turkey. Electronic address: dryalcingolcuk@gmail.com.
authors: Yalcin
authors: Y
authors: Golcuk
authors: Merkez Efendi State Hospital, Department of Clinical Biochemistry, Manisa, Turkey.
authors: Burcu
authors: B
authors: Golcuk
authors: Celal Bayar University, Faculty of Medicine, Department of Emergency Medicine, Manisa, Turkey.
authors: Adnan
authors: A
authors: Bilge
authors: Celal Bayar University, Faculty of Medicine, Department of Emergency Medicine, Manisa, Turkey.
authors: Mehmet
authors: M
authors: Irik
authors: Celal Bayar University, Faculty of Medicine, Department of Emergency Medicine, Manisa, Turkey.
authors: Onur
authors: O
authors: Dikmen
mesh_terms: D000368:Aged; D002423:Cause of Death; D017714:Community-Acquired Infections / Q000097:blood* / Q000401:mortality*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D011014:Pneumonia / Q000097:blood* / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology