title: Prognostic impact of platelet distribution width in patients with Crimean-Congo hemorrhagic fever.
abstract: Platelet distribution width (PDW) is a readily available blood test involving calculations performed by automated blood analyzers. Crimean-Congo hemorrhagic fever (CCHF) may exhibit a severe profile with fatal hemorrhaging or else present with a mild clinical process. The purpose of our study was to investigate the importance of PDW in CCHF patients and its clinical prognostic value. This study was conducted with patients with CCHF. Patients were divided into two groups on the basis of presence or absence of bleeding. Demographic characteristics, clinical findings, PDW, and other laboratory tests were recorded onto forms. A total of 423 patients were included. Hemorrhaging was observed in 27.9% during hospitalization. PDW on the first day of hospitalization was 17.2 ± 0.9% in the hemorrhagic patients and 17.1 ± 0.6% in the cases without hemorrhage (P = 0.290). On the third day of hospitalization, PDW was 17.6 ± 0.8% in the hemorrhagic patients and 17.0 ± 0.7% in the cases without hemorrhage (P < 0.001). At a third-day PDW level cut-off point of 17.1%, AUROC was 0.677, sensitivity 65.5%, specificity 54.6%, PPV 35.5%, and NPV 80.6%. A one-unit raise in third day PDW stepped up the probability of bleeding in patients with CCHF 3.45-fold at logistic regression analysis. This study shows that PDW is a parameter that may be used to determine disease severity. This parameter may be at least as useful as platelet count in helping clinicians identify severe cases. Early identification of cases with a severe course will make it possible to provide early planning of modalities such as intensive care support. J. Med. Virol. 88:1862-1866, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Medical Biochemistry, Kanuni Training and Research Hospital, Trabzon, Turkey.
authors.forename: Hülya
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Gürdal
authors.initials: G
authors.lastname: Yilmaz
authors.affiliation: Faculty of Medicine, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Menteşe
authors.affiliation: Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University, Rize, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Kostakoğlu
authors.affiliation: Faculty of Medicine, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Süleyman Caner
authors.initials: SC
authors.lastname: Karahan
authors.affiliation: Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: İftihar
authors.initials: İ
authors.lastname: Köksal
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000502:physiology*; D019353:Endemic Diseases; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000302:isolation & purification / Q000502:physiology; D006479:Hemorrhagic Fever, Crimean / Q000097:blood* / Q000175:diagnosis* / Q000821:virology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D010979:Platelet Function Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Crimean-Congo hemorrhagic fever; biochemical analysis; endemic infection