Correlation of platelet count and platelet indices with neonatal sepsis-diagnostic and prognostic indicator

Background: Neonatal sepsis is major cause of neonatal morbidity and mortality worldwide. Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. Platelet indices are one such set of parameters which can be helpful in the future diagnosis of neonatal sepsis. This study was aimed to evaluate the significance of platelet indices either alone or in combination with existing sepsis screen as a marker of neonatal sepsis.Methods: Neonates admitted in the neonatal unit of Hospital and showing signs and symptoms of sepsis, and/or born to mothers with risk factor for sepsis were included in this study. Investigations sent for all these neonates included blood culture, sepsis screen (CRP, micro ESR, TLC, ANC, IT ratio) and platelet indices (Platelet count, MPV, PDW).Results: In present study, 81.12% neonates in case group had platelet count less than 1.5lacs/mm3 while in control group 20.91% neonates only had the same. This difference was statistically significant, (p<0.0001). Similarly, 70.91% neonates in case group had MPV more than >10.8 fl whereas in control group only 26.53% neonates had the same, with difference was statistically significant, (p<0.0001) Similarly, 65.81% neonates in case group and 34.69% in control group had PDW more than 19.1fl and this difference was statistically significant, (p=0.0001).Conclusions: High PDW, high MPV and low platelet count are more associated with neonatal sepsis. So, platelet and its indices may be used as a sensitive marker to identify septic babies and it may be combined with existing sepsis screen to specifically exclude non-septic case.

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A PROSPECTIVE OBSERVATIONAL STUDY FOR RELATIONSHIP BETWEEN THROMBOCYTOPENIA AND CULTURE POSITIVE NEONATAL BACTERIAL SEPSIS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1121 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Anita Devi ◽

Rakesh Kumar Sharma ◽

Kapil Kumar

Keyword(s):

Platelet Count ◽

Observational Study ◽

Neonatal Sepsis ◽

Prospective Observational Study ◽

Hematological Parameters ◽

Clinical Signs ◽

Sepsis Group ◽

P Value ◽

Distribution Width ◽

Platelet Indices

Background: Changes in Platelet parameters like Mean Platelet Volume and Platelet Distribution Width are helpful in diagnosis of neonatal sepsis but these indices have not been extensively studied in neonatal sepsis. Hence, the present study is undertaken to evaluate Platelet count and platelet indices in diagnosis of neonatal sepsis. Methods: This prospective observational study was conducted over a period of 4 months i.e from December 2019 to March 2020 in neonatal intensive care unit of Jhalawar Medical College & Attached Hospitals, Jhalawar. During the study period 154 consecutive neonates (both inborn and out born), with clinical signs and symptoms of sepsis along with either positive culture (confirmed neonatal sepsis ) or other laboratory findings suggestive of bacterial and fungal infection in absence of positive cultures (probable sepsis), were included after written informed consent from parents. Results: Out of total (154), 81.8%, 76% and 67.5% of cases had thrombocytopenia, raised MPV (>10.8) and raised PDW respectively. As compared to Non-sepsis group, MPV values were raised in more cases of Sepsis proven group (88%) and the difference was statistically significant with P value of 0.011. PDW values were also more increased in Sepsis proven group compared to Non-sepsis group. Conclusion: Platelet count and platelet indices, which are easily available hematological parameters in remote & resource poor areas of our country, should be taken into consideration for suspected cases of neonatal sepsis so that prompt treatment can be given, and morbidity and mortality can be reduced. Keywords: Sepsis, CRP, MPV, PDW.

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A STUDY ON PLATELET COUNT AND PLATELET INDICES IN NEONATAL SEPSIS IN A TERTIARY CARE CENTER

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i9.2187 ◽

2021 ◽

Vol 5 (9) ◽

Author(s):

Neha Sharma ◽

G S Senger ◽

Seema Meena ◽

Priyanka Sharma

Keyword(s):

Platelet Count ◽

Neonatal Sepsis ◽

Hematological Parameters ◽

Care Center ◽

Tertiary Care ◽

Clinical Signs ◽

Sepsis Group ◽

P Value ◽

Distribution Width ◽

Platelet Indices

Background: The present study is undertaken to evaluate Platelet count and platelet indices in diagnosis of neonatal sepsis. Methods: This prospective observational study was conducted on 100 consecutive neonates (both inborn and out born), with clinical signs and symptoms of sepsis along with either positive culture (confirmed neonatal sepsis ) or other laboratory findings suggestive of bacterial and fungal infection in absence of positive cultures (probable sepsis), were included after written informed consent from parents. Results: 71 (71.00%) out of 100 cases had increased values of Platelet Distribution Width. In Proven sepsis group 31(86.11%) cases had increased values of PDW, in Probable sepsis 31(63.27%) and in No sepsis group 9(60.00%) cases were having increased values of PDW. This difference was statistically not significant (P value is 0.08). Conclusion: Platelet count and platelet indices, which are easily available hematological parameters in remote & resource poor areas of our country, should be taken into consideration for suspected cases of neonatal sepsis so that prompt treatment can be given, and morbidity and mortality can be reduced. Keywords: Sepsis, TPC, MPV, PDW.

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ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i2.1185 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Tanwi Singh ◽

Anshuman Sinha

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Screening Test ◽

Low Cost ◽

Medical Science ◽

Cost Effective ◽

Platelet Indices ◽

Increased Risk ◽

Low Platelet Count ◽

Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

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Blood Platelet Count at Hospital Admission Impacts Long-Term Mortality in Patients with Acute Coronary Syndrome

Cardiology ◽

10.1159/000505640 ◽

2020 ◽

Vol 145 (3) ◽

pp. 148-154 ◽

Cited By ~ 1

Author(s):

Artur Małyszczak ◽

Agata Łukawska ◽

Izabela Dyląg ◽

Weronika Lis ◽

Andrzej Mysiak ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Platelet Count ◽

Mortality Rate ◽

Hospital Admission ◽

Cox Proportional Hazards Model ◽

Distribution Width ◽

Platelet Indices ◽

Coronary Syndrome ◽

Long Term Mortality

Introduction: Platelets play a fundamental role in the pathogenesis of acute coronary syndrome (ACS). The platelet count (PC) at hospital admission is easy to obtain, but whether thrombocytopenia or/and thrombocytosis impact long-term mortality (LTM) after ACS is unclear. Objective: To evaluate the effect of PC at hospital admission on LTM in patients with ACS. Methods: This retrospective cohort study included patients with the ICD-10 codes for unstable angina (I.20) and acute myocardial infarction (I.21, I.22). Thrombocytopenia was defined as a blood PC <150 G/L and thrombocytosis as a PC >450 G/L. Additional platelet indices which were tested included plateletcrit (PCT), the mean platelet volume (MPV), the platelet distribution width (PDW), and the platelet larger cell ratio (P-LCR). Data on all-cause death were obtained from the National Health Fund database. Results: The study included 3,162 patients with a median follow-up of 27.2 months (interquartile range 12.5–46.8 months; max 68.7 months). Patients with thrombocytopenia and thrombocytosis yielded a higher maximal analyzed 5-year mortality rate in comparison with normal PC patients (45.8 and 47.7 vs. 24.2%, respectively; p < 0.00001) which was mainly driven by higher deaths at 1–2 years after ACS. The 5-year LTM was also significantly higher in patients with abnormal PCT and MPV levels in comparison with patients with PCT and MPV within the normal range. Other platelet indices (PDW, P-LCR) were not associated with a worse outcome. The Cox proportional hazards model revealed that thrombocytopenia at admission was independently associated with higher LTM after ACS (RR 1.83; 95% CI 1.1–3.0; p = 0.01). Conclusions: Both thrombocytopenia and thrombocytosis at hospital admission in post-ACS patients are associated with a significant almost two times higher 5-year mortality rate.

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A study on platelet count and their indices as a marker of neonatal sepsis

International Journal of Paediatrics and Geriatrics ◽

10.33545/26643685.2021.v4.i1b.131 ◽

2021 ◽

Vol 4 (1) ◽

pp. 72-78

Author(s):

Dr. Hajra Tabassum

Keyword(s):

Platelet Count ◽

Neonatal Sepsis

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A pattern of platelet indices as a potential marker for prediction of pre-eclampsia among pregnant women attending a Tertiary Hospital, Ethiopia: A case-control study

PLoS ONE ◽

10.1371/journal.pone.0259543 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259543

Author(s):

Solomon Gebre Bawore ◽

Wondimagegn Adissu ◽

Berhanu Niguse ◽

Yilma Markos Larebo ◽

Nigussie Abebe Ermolo ◽

...

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Mean Platelet Volume ◽

Case Control Study ◽

Case Control ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Control Study

Introduction Preeclampsia is the most serious health risk during pregnancy for both the mother and the fetus. Even though platelet parameters are among the proposed biomarkers for the prediction of preeclampsia, the use of its indices in the diagnosis of preeclampsia is not increasing in Ethiopia. There is little information on platelet patterns in preeclampsia and normal pregnancy. The purpose of this study was to determine the pattern of platelet indices in women with preeclampsia in our study setting. Methods A case-control study was conducted among 180 pregnant women who attended anti-natal follow-ups from January 1 to April 3, 2019. An Ethylene Diamine Tetra Acetic Acid anti-coagulated venous blood was collected and analyzed using a hematology analyzer (MINDRAY®-BC-300Plus, Shenzhen China). The SPSS software version 26 was used to run the Mann Whitney U test, Kruskal-Wallis H test, and Kolmogorov-Smirnov normality test, Post-hock test augmented with Benforeni, receiver operating characteristics curve, and Spear Man rank-order correlation. A P-value of <0.05 was considered statistically significant. Results A total of 180 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In contrast, the mean platelet volume and platelet distribution widths were significantly increased with the severity of preeclampsia (P<0.001). Platelet distribution width (rho = 0.731, p<0.001) and mean platelet volume (rho = 0.674, p<0.001) had statistically significant positive relationships with mean arterial pressure. The best metric for predicting preeclampsia was platelet distribution width (AUC = 0.986; 95%CI; 0.970, 1). Conclusions Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.

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Role of platelet distribution width and plateletcrit in assessment of nonthrombocytopenic preeclampsia and eclampsia in a tertiary care hospital of Odisha: an observational study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201795 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1996

Author(s):

Kirtirekha Mohapatra ◽

Pranati Mohanty ◽

Nahida Nigar Sultana

Keyword(s):

Platelet Count ◽

Observational Study ◽

Severe Disease ◽

Tertiary Care ◽

Measurement Tool ◽

Care Hospital ◽

Platelet Distribution Width ◽

Distribution Width ◽

Platelet Indices

Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.

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Evaluation of Microbiologic and Hematologic Parameters and E-Selectin as Early Predictors for Outcome of Neonatal Sepsis

Archives of Pathology & Laboratory Medicine ◽

10.5858/133.8.1291 ◽

2009 ◽

Vol 133 (8) ◽

pp. 1291-1296 ◽

Cited By ~ 1

Author(s):

Maysaa El Sayed Zaki ◽

Hesham El Sayed

Keyword(s):

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Newborn Infants ◽

Prognostic Indicator ◽

Diagnostic Value ◽

Total Leukocyte Count ◽

C Reactive Protein ◽

Gram Negative ◽

Reactive Protein ◽

Early Predictors

Abstract Context.—Early diagnosis of neonatal sepsis is mandatory. Various markers are used to diagnose the condition. Objective.—To evaluate the diagnostic value of various clinical data and hematologic parameters, such as total leukocyte count, absolute neutrophil count, immature to total neutrophil ratio, and soluble E-selectin (sE-selectin) in identification and outcome of neonatal sepsis. Design.—Newborn infants with a clinical diagnosis of sepsis in the neonatal intensive care unit at Mansoura University Children's Hospital during the period between July 2007 and December 2007 were eligible for study. In addition, 30 healthy neonates were included in the study. Complete hematologic and microbiologic laboratory investigations were performed, and serum E-selectin was measured. Results.—Plasma sE-selectin levels were significantly higher (P < .001) in infected infants (mean [SD], 156.9 [77.0] ng/mL) than in noninfected (mean [SD], 88.8 [47.1] ng/mL) and healthy infants (mean [SD], 8.67 [3.74] ng/ mL). Infants with gram-negative sepsis had higher sE-selectin levels than did those with gram-positive sepsis (P = .04). C-reactive protein was the best laboratory test for diagnosis of neonatal sepsis, with an overall sensitivity and specificity of 86% and 97%, respectively. Performing sE-selectin with C-reactive protein or immature to total ratio tests increased the specificity, but reduced the sensitivity, of the tests for the determination of neonatal sepsis. Plasma sE-selectin levels were higher in nonsurvivors than in survivors (P = .01) and were higher in those with hemodynamic dysfunction than in those without hemodynamic dysfunction (P < .001). Conclusions.—We conclude that plasma sE-selectin levels are elevated in neonatal sepsis. Significant elevation was associated with gram-negative sepsis. Plasma sE-selectin had low diagnostic value when used alone or in combination with other tests; however, it can be used as a prognostic indicator for the outcome of neonatal sepsis.

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