title: Mean platelet volume and mean platelet volume/platelet count ratio in risk stratification of pulmonary embolism.
abstract: OBJECTIVE
  Recently, some of the hemogram parameters were reported to predict early death in acute pulmonary embolism (PE). The aim of this study was to investigate the role of mean platelet volume (MPV) and MPV/platelet count ratio (MPV/P), WBC and red cell distribution width (RDW) in risk stratification of patients with acute PE.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with acute PE admitted to the Emergency Department. In addition to the clinical evaluation, the hemogram parameters were measured on admission.
  
  
  RESULTS
  A total of 152 patients were included. Patients with RV dysfunction had significantly higher MPV levels and MPV/P than patients without RV dysfunction. Receiver operating characteristic curve analysis revealed that a MPV cut-off of 7.85fL provided a sensitivity of 53.3% and a specificity of 68.5%, and a MPV/P cut-off of 0.0339fL/(10(9)/L) provided a sensitivity of 69.6% and a specificity of 65% for the prediction of RV dysfunction. There was a positive correlation between MPV and systolic pulmonary artery pressure (SPAP) and between MPV and RV diameter. There was a positive correlation between MPV/P and SPAP and between MPV/P and RV diameter. The low-risk PE group had lower MPV and MPV/P than the massive PE and submassive PE groups.
  
  
  CONCLUSIONS
  MPV and MPV/P were found to be associated with RV dysfunction and clinical severity in acute PE. Low MPV and MPV/P levels may be an indicator of low risk and, high WBC levels may be an indicator of high risk in patients with acute PE. RDW levels may not reflect severity of acute PE.
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. Electronic address: tyardan@yahoo.com.
authors.forename: Turker
authors.initials: T
authors.lastname: Yardan
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Meric
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Kati
authors.affiliation: Department of Emergency Medicine, Van Training and Research Hospital, Van, Turkey.
authors.forename: Yildiray
authors.initials: Y
authors.lastname: Celenk
authors.affiliation: Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Atilla Guven
authors.initials: AG
authors.lastname: Atici
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D011655:Pulmonary Embolism / Q000097:blood* / Q000401:mortality*; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000453:epidemiology; D055815:Young Adult
keywords: Mean platelet volume; Pulmonary embolism; Red cell distribution width; Right ventricular dysfunction; White blood cells