scholarly journals Diagnostic Role of Mean-Platelet Volume in Acute Pulmonary Embolism: A Meta-analysis and Systematic Review

2020 ◽  
Vol 14 ◽  
pp. 117954842095636
Author(s):  
Cláudia Febra ◽  
Ana Macedo
Keyword(s):  
Pulmonary Embolism ◽  
Mean Platelet Volume ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Control Group ◽  
Significant Heterogeneity ◽  
Platelet Volume ◽  
Diagnostic Role ◽  
Acute Pe

Background: Acute pulmonary embolism (PE) is the third most fatal cardiovascular disease. PE is frequently misdiagnosed due to its clinical presentation’s heterogeneity and the inexistence of biomarkers for its immediate diagnosis. Mean platelet volume (MPV) has shown a potential role as a biomarker in acute PE. In this analysis, we aimed to systematically compare the MPV in patients with and without definite diagnosis of PE, in emergency departments. Methods: Embase, PubMed and Medline were searched for relevant publications, in English. The main inclusion criteria were studies which compared MPV in patients with acute PEA versus a control group. Results: Thirteen studies consisting of a total number of 2428 participants were included. Of the participants included, 1316 were patients with confirmed acute PE, and 1112 were assigned to the control group. MPV was significantly higher in patients with acute PE than in controls (RR: 0.84, 95% CI: 0.76 – 0.92; P < .00001). There was a significant heterogeneity in the data. Conclusions: This analysis showed higher MPV to be associated with acute PE immediate diagnosis. These data show promise for the use of MPV as a readily available biomarker for the diagnosis of acute PE at the emergency department.

Diagnostic Role Of MPV In Acute Appendicitis

2020 ◽  
pp. 10-13
Author(s):  
◽  
Keyword(s):  
Acute Appendicitis ◽  
Mean Platelet Volume ◽  
Pathological Diagnosis ◽  
Control Group ◽  
Healthy Children ◽  
Platelet Volume ◽  
Blood Samples ◽  
Diagnostic Role ◽  
And Control

Introduction: The aim of this study was to investigate the diagnostic role of mean platelet volume (MPV) for acute appendicitis. Methods: Patient files were retrospectively observed. MPV of 311 patients with pathological diagnosis of acute appendicitis were compared with the MPV of 314 healthy children (blood samples were taken for elective operations). SPSS (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.) was used to evaluate the results. Results: 188 of acute appendicitis were male (%60.5). Mean age of acute appendicitis group was 10.22±3.83. MPV of children with the diagnosis of acute appendicitis (8.37±0.83fL) and the control group (10.55±0.83fL). MPV values were statistically different between the acute appendicitis and control group (p<0,001). Conclusion: MPV may be used as a marker for the diagnosis of acute appendicitis, but it is not a specific biomarker for appendicitis.

Diagnostic role of mean platelet volume in tonsillitis with and without peritonsillar abscess

2018 ◽  
Vol 132 (7) ◽  
pp. 615-618
Author(s):  
Y Nakao ◽  
T Tanigawa ◽  
F Kano ◽  
H Tanaka ◽  
N Katahira ◽  
...  
Keyword(s):  
Mean Platelet Volume ◽  
Laboratory Data ◽  
Peritonsillar Abscess ◽  
Control Group ◽  
Platelet Volume ◽  
Protein Levels ◽  
Cell Counts ◽  
Diagnostic Role ◽  
White Blood Cell Counts

AbstractObjectiveTo assess the diagnostic role of mean platelet volume in tonsillitis with and without peritonsillar abscess.MethodsMean platelet volume and other laboratory data were retrospectively investigated.ResultsMean platelet volume was significantly lower in the tonsillitis group (7.8 per cent ± 0.7 per cent) than in the control group (8.7 per cent ± 0.6 per cent; p < 0.0001), and it was significantly lower in the abscess group (7.5 per cent ± 0.6 per cent) than in the no abscess group (8.0 per cent ± 0.7 per cent; p = 0.0277). White blood cell counts and C-reactive protein levels were not significantly different between patients with an abscess and those without. The mean platelet volume cut-off values for the diagnosis of tonsillitis and peritonsillar abscess were 7.95 fl and 7.75 fl, respectively.ConclusionOur results suggest that a decreased mean platelet volume is associated with the development and severity of tonsillitis. This finding provides useful diagnostic information for physicians treating patients with tonsillitis.

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Jie Li ◽  
Lei Feng ◽  
Jiangbo Li ◽  
Jian Tang
Keyword(s):  
Pulmonary Embolism ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Diagnostic Accuracy ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Acute Pe ◽  
Limited Sensitivity

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

A novel echocardiographic parameter for assessment of right ventricular function in acute pulmonary embolism: an experimental study

2019 ◽  
Author(s):  
Decai Zeng ◽  
Ji Wu ◽  
Hui Chen ◽  
Ying Tan ◽  
Xueyu Che ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Autologous Blood ◽  
Left Ventricular ◽  
Control Group ◽  
Tei Index ◽  
Significant Difference ◽  
Acute Pe ◽  
Rv Function

Abstract Background Right ventricular (RV) dysfunction played a decisive role in clinical management and associated with poor prognosis in acute pulmonary embolism (PE). It still remains challenging to estimate RV function accurately for the reason of complex structure and geometry. The present study aimed to determine the value of right ventricular outflow tract systolic excursion (RVOT-SE) in evaluating RV function in an animal model with acute PE. Methods Thirty-three healthy New Zealand rabbits were randomly assigned to massive thrombus group, sub-massive thrombus group and control group, 11 rabbits per group. The acute PE model was established by intravenous infusion of autologous blood clots. After 1h of thrombus injection, transthoracic echocardiography was performed to assess RV function in all rabbits. Results The acute PE model was successfully made in 18 rabbits (massive thrombus group, n = 8; sub-massive thrombus group n = 10). Right/left ventricular end-diastolic diameter (RV/LV) ratio and RV myocardial performance (Tei) index were significantly increased, while RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE) and RVOT_SE were reduced in massive thrombus group. The value of RVOT-SE and RVFAC in sub-massive thrombus group decreased significantly compared with control group (P < 0.05). But there was no significant difference in RV/LV, TAPSE and Tei index (P > 0.05). ROC analysis showed that RVOT-SE had high sensitivity (94.4%) and specificity (72.7%) in identifying RV dysfunction in acute PE. The area under the ROC curve (AUC) for combined TAPSE and RVOT-SE was greater than that of TAPSE or RVOT-SE alone (AUC= 0.962, P < 0.01). Conclusion RV function in acute PE is significantly decreased, which is closely related to the size of embolus. RVOT_SE is a simple and highly distinctive parameter in identifying RV dysfunction and tends to be superior to conventional parameters in acute PE. The combination of RVOT-SE and TAPSE can further improve the diagnostic accuracy of acute PE.

scholarly journals Current Endovascular Treatment Options in Acute Pulmonary Embolism

2021 ◽  
Vol 11 ◽  
pp. 5
Author(s):  
Kelli Moore ◽  
Jeff Kunin ◽  
Mohammed Alnijoumi ◽  
Prashant Nagpal ◽  
Ambarish P. Bhat
Keyword(s):  
Pulmonary Embolism ◽  
Endovascular Treatment ◽  
Acute Pulmonary Embolism ◽  
Treatment Options ◽  
Mortality And Morbidity ◽  
Response Team ◽  
Promising Treatment ◽  
Level I ◽  
Acute Pe

Acute pulmonary embolism (PE) is a significant cause of mortality and morbidity across the globe. Over the last few decades, there have been major therapeutic advances in acute PE management, including catheter-based therapy. However, the effectiveness of catheter-based therapy in acute PE is not supported by Level I evidence, making the use of this promising treatment rather controversial and ambiguous. In this paper, we discuss the risk stratification of acute PE and review the medical and endovascular treatment options. We also summarize and review the data supporting the use of endovascular treatment options in acute PE and describe the potential role of the PE response team.

Intrapulmonary Artery Thrombolysis in Acute Pulmonary Embolism: Case Series from King Chulalongkorn Memorial Hospital Experience

2021 ◽  
Vol 104 (8) ◽  
pp. 1376-1380
Keyword(s):  
Pulmonary Embolism ◽  
Plasminogen Activator ◽  
Acute Pulmonary Embolism ◽  
Case Series ◽  
Systemic Thrombolysis ◽  
Tissue Plasminogen ◽  
Surgical Embolectomy ◽  
Surgical Thrombectomy ◽  
Acute Pe

Acute pulmonary embolism (PE) is a life-threatening condition. In patient who has contraindication for systemic thrombolysis and inappropriate for surgical embolectomy, there is a role of catheter interventions. However, the data are limited. The aim of the present report was to assess a role of intrapulmonary artery thrombolysis bolus in acute PE. A retrospective review of the use of intrapulmonary artery thrombolysis in acute PE. The data were collected from 14 patients with massive or submassive PE who had contraindication or inappropriate for systemic thrombolysis and unsuitable for surgical embolectomy. After intrapulmonary thrombolysis was given, patients were followed clinically and hemodynamically until discharged and after 1 month. Pulmonary pressure was collected at pre and post intervention. Of the 14 patients (age 59±19 years, 78.6% female), 86% were diagnosed as submassive PE. Mean dose of tissue plasminogen activator (rt-PA) was 28±14 mg given as bolus and continuous infusion (19±10 hours). One patient died after completion of intrapulmonary infusion rt-PA at day 90, which did not relate to PE and the treatment. After intervention, mean PA pressure was significantly reduced from 32.3±6.0 to 21.0±4.3 mmHg (p<0.001). Three patients (21%) had minor bleeding (hematoma at access site). The present case series showed that intrapulmonary infusion of rt-PA was effective and safe in patient with massive and submassive PE who had contraindication or inappropriate to systemic thrombolysis or inoperable surgical thrombectomy. Keywords: Acute pulmonary embolism; Intrapulmonary thrombolysis; Tissue plasminogen activator; Surgical thrombectomy

scholarly journals Clinical Method Applied to Focused Ultrasound: The Case of Wells’ Score and Echocardiography in the Emergency Department: A Systematic Review and a Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 766
Author(s):  
Lorenzo Falsetti ◽  
Vincenzo Zaccone ◽  
Alberto M. Marra ◽  
Nicola Tarquinio ◽  
Giovanna Viticchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Right Ventricle ◽  
Meta Analysis ◽  
Diagnostic Role ◽  
Wells Score ◽  
Risk Patients ◽  
Low Sensitivity

Background and Objectives: bedside cardiac ultrasound is a widely adopted method in Emergency Departments (ED) for extending physical examination and refining clinical diagnosis. However, in the setting of hemodynamically-stable pulmonary embolism, the diagnostic role of echocardiography is still the subject of debate. In light of its high specificity and low sensitivity, some authors suggest that echocardiographic signs of right ventricle overload could be used to rule-in pulmonary embolism. In this study, we aimed to clarify the diagnostic role of echocardiographic signs of right ventricle overload in the setting of hemodynamically-stable pulmonary embolism in the ED. Materials and Methods: we performed a systematic review of literature in PubMed, Web of Science and Cochrane databases, considering the echocardiographic signs for the diagnosis of pulmonary embolism in the ED. Studies considering unstable or shocked patients were excluded. Papers enrolling hemodynamically stable subjects were selected. We performed a diagnostic test accuracy meta-analysis for each sign, and then performed a critical evaluation according to pretest probability, assessed with Wells’ score for pulmonary embolism. Results: 10 studies were finally included. We observed a good specificity and a low sensitivity of each echocardiographic sign of right ventricle overload. However, once stratified by the Wells’ score, the post-test probability only increased among high-risk patients. Conclusions: signs of echocardiographic right ventricle overload should not be used to modify the clinical behavior in low- and intermediate- risk patients according to Wells’ score classification. Among high-risk patients, however, echocardiographic signs could help a physician in detecting patients with the highest probability of pulmonary embolism, necessitating a confirmation by computed tomography with pulmonary angiography. However, a focused cardiac and thoracic ultrasound investigation is useful for the differential diagnosis of dyspnea and chest pain in the ED.

scholarly journals Is there a diagnostic value for the platelet indices patients in pulmonary embolism?

2017 ◽  
Vol 25 (2) ◽  
pp. 91-94
Author(s):  
İbrahim Çevik ◽  
Hüseyin Narcı ◽  
Güllü Akbaydoğan Dündar ◽  
Cüneyt Ayrık ◽  
Seyran B Babuş
Keyword(s):  
Pulmonary Embolism ◽  
Mean Platelet Volume ◽  
Area Under The Curve ◽  
Control Group ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Platelet Indices ◽  
Platelet Number ◽  
D Dimer

Background: Pulmonary embolism is a common disease with a high mortality risk. It has recently been reported that platelet indices may be diagnostic in pulmonary embolism. Objective: In this study, we aimed to determine the diagnostic value of platelet indices in acute pulmonary embolism. Methods: The study group was composed of 61 patients diagnosed with pulmonary embolism and a control group of 67 subjects without pulmonary embolism. Patient age, sex, leukocyte and platelet number, hemoglobin concentration (Hb), mean platelet volume, platelet distribution width, red blood cell distribution width, C-reactive protein, D-Dimer, and troponin I levels were retrospectively analyzed and compared between the two groups. Results: There was no significant difference between age and platelet number of pulmonary embolism and control group. In pulmonary embolism group, platelet distribution width level was significantly high (p = 0.002), whereas mean platelet volume level was significantly lower (p = 0.038). Receiver operating characteristic curve analysis revealed that a mean platelet volume cut-off of 9 fL had a sensitivity of 35%, a specificity of 89.55%, and area under the curve of 0.589 for pulmonary embolism, while a platelet distribution width cut-off of 12.8 fL had a sensitivity of 61%, a specificity of 71.64%, and area under the curve of 0.661. Platelet distribution width and D-dimer levels had a significant positive correlation with each other, whereas there was no significant correlation between mean platelet volume and D-dimer. Conclusion: Platelet distribution width values of the pulmonary embolism group were higher than those of control group. Although the area under the curve of platelet distribution width is slightly better than for platelet number or mean platelet volume, it does not seem that this parameter has better diagnostic accuracy than the other two.

scholarly journals The value of ecocardiographic in diagnostication and management of pacients with acute pulmonary embolism

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Tatiana Cuzor ◽  
◽  
Nadejda Diaconu ◽  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Thromboembolism ◽  
Fatal Disease ◽  
Right Ventricle Dysfunction ◽  
Additional Information ◽  
Risk Patients ◽  
Acute Pe

Pulmonary thromboembolism (TP) remains an underdiagnosed fatal disease at the emergency unit that suggests the need for alternative noninvasive approaches to rapid diagnosis. The role of echocardiography in acute pulmonary embolism (EP) remains incompletely defined. Echocardiography cannot reliably diagnose acute EP and does not improve the prognosis of patients with low-risk acute PE, who lack other clinical characteristics of right ventricle dysfunction (VD). However, echocardiography and dopplerography of the venous system may produce additional information in high-risk patients and may help differentiate chronic VD dysfunction. Specific echocardiographic predictors of VD dysfunction have the potential to increase prognosis in patients at high risk of TP.

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