title: Preoperative platelet count and volume could not help predict PONV in women undergoing breast cancer surgery: A prospective cohort study.
abstract: Postoperative nausea and vomiting (PONV) still represents one of the most distressing side effects of anaesthesia and surgery. Clinical risk scores e.g. Apfel score is today commonly used to identify patients at risk. We found in a previous study different platelet counts in patients with and without PONV. The aim of the present explorative study was to assess whether females experiencing PONV after breast surgery had any difference in preoperative platelet count and/or volume assessed by platelet testing.
  
  
  METHODS
  All women scheduled for elective breast cancer surgery at Danderyds Hospital, Stockholm, Sweden, during one year were asked to participate in this study. Occurrence of PONV during the 24 first postoperative hours was studied. Blood samples collected preoperatively were analysed by platelet counts determined by impedance (PTLi) and optical (PTLo) methods, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT). Platelet data were compared between patients with and without PONV.
  
  
  RESULTS
  In all 183 patients were included in the study, 65 (35%) suffered from PONV, increasing incidence with increased risk score 4 out 5 with 4 risk factors. Mean platelet count was 266 [114-538], mean platelet volume 8.59 [5.94-12.1] and mean platelet weight 16.17 [14.2-25.9] but no differences in any platelet test variables studied were found between patients with or without PONV or with increasing risk factors.
  
  
  CONCLUSIONS
  One third of patients' experienced PONV, increased incidence associated to Apfel score but platelet numbers and simple platelet test provided no additional information around risk for PONV.
authors.affiliation: KarolinskaInstitutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, SE-188 82 Stockholm, Sweden. Electronic address: Emma.obrink@ds.se.
authors.forename: E
authors.initials: E
authors.lastname: Öbrink
authors.affiliation: Childhood Cancer Research Unit, Department of Women's and Children's Health, KarolinskaInstitutet, SE-171 76 Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Eksborg
authors.affiliation: Section of Anaesthesiology & Intensive Care, Dept of Physiology & Pharmacology, KarolinskaInstitutet, SE-171 77 Stockholm, Sweden.
authors.forename: P-A
authors.initials: PA
authors.lastname: Lönnqvist
authors.affiliation: KarolinskaInstitutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, SE-188 82 Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Oddby-Muhrbeck
authors.affiliation: KarolinskaInstitutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, SE-188 82 Stockholm, Sweden.
authors.forename: J G
authors.initials: JG
authors.lastname: Jakobsson
mesh_terms: D001943:Breast Neoplasms / Q000097:blood* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D063847:Mean Platelet Volume; D010976:Platelet Count; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis*; D057234:Preoperative Period; D011446:Prospective Studies; D012307:Risk Factors
keywords: Breast surgery; PONV; Platelet; Risk score