Reliability of Haematological Parameters and Ratios Obtained from Automated Haematology Analysers in Predicting the Clinical Condition of the Patient - A Study from a Tertiary Care Hospital in New Delhi

2021 ◽  
Vol 8 (25) ◽  
pp. 2168-2172
Author(s):  
Anjali Sharma ◽  
Manju Kumari ◽  
Heena Heena ◽  
Mukul Singh ◽  
Sunil Ranga ◽  
...  
Keyword(s):  
Intensive Care ◽  
Platelet Count ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Platelet Volume ◽  
Platelet Indices ◽  
Lymphocyte Ratio ◽  
Significant Difference

BACKGROUND Modern automated analysers provide various haematological parameters which have gained a lot of clinical significance. Of these, platelet indices are the most recent one which need to be explored in various diseases. The present study was conducted to evaluate the significance of platelet indices, neutrophil-tolymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and mean platelet volume–to-platelet count in critically ill patients. METHODS This is a prospective study carried out in emergency laboratory of pathology department. 100 patients of intensive care units (ICU) and non-intensive care units (Non-ICU) visiting to the emergency department were included in the study. Fortyfive age and sex matched control patients were taken. The ethylenediamine tetra acetic acid (EDTA) blood sample was analysed on automated analyser. Platelet indices, NLR, MLR and mean platelet volume to platelet counts were calculated in ICU, Non-ICU and control groups. All these values were compared among these groups. RESULTS The study included 400 patients (200 critically ill and 200 non-critically ill) and 45 healthy controls from normal population. The male to female ratio in critically ill and non-critically ill patients was 1.3 : 1 (113 : 87) and 1.08 : 1 (104 : 96) respectively. The critically ill patients had significant leucocytosis (P = 0.019) with neutrophilia (P = 0.005) and lymphopenia (P = 0.048) when compared to noncritically ill patients. There was a significant difference of NLR (P = 0.010), MLR (P = 0.027) and MPV : Platelet count (P = 0.045) in these two groups. However, platelet count and platelet indices were not showing any significant difference in these groups. CONCLUSIONS In the era of modern auto analysers, we should try to utilize the maximum information that could be provided by these machines in forms of various indices and ratios. The present study highlights that neutrophilic leucocytosis with lymphopenia is seen in critically ill patients when compared to non-critically ill patients and normal control population. NLR, MLR and MPV to platelet ratios are also of great importance whereas platelet count and platelet indices are always not helpful in categorization of severity of the patient’s condition. KEYWORDS Intensive Care Unit Patients, Neutrophil Lymphocyte Ratio, Monocyte Lymphocyte Ratio, Mean Platelet Volume

scholarly journals Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia?

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Dragan Djordjevic ◽  
Goran Rondovic ◽  
Maja Surbatovic ◽  
Ivan Stanojevic ◽  
Ivo Udovicic ◽  
...  
Keyword(s):  
Platelet Count ◽  
Critically Ill ◽  
Mean Platelet Volume ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Lethal Outcome ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Injured Patients

Background. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count (MPV/PC) ratio are readily available parameters that might have discriminative power regarding outcome. The aim of our study was to assess prognostic value of these biomarkers regarding outcome in critically ill patients with secondary sepsis and/or trauma. Methods. A total of 392 critically ill and injured patients, admitted to surgical ICU, were enrolled in a prospective observational study. Leukocyte and platelet counts were recorded upon fulfilling Sepsis-3 criteria and for traumatized Injury Severity Score > 25 points. Patients were divided into four subgroups: peritonitis, pancreatitis, trauma with sepsis, and trauma without sepsis. Results. NLR and MPV/PC levels were significantly higher in nonsurvivors (AUC/ROC of 0.681 and 0.592, resp., in the peritonitis subgroup; 0.717 and 0.753, resp., in the pancreatitis subgroup); MLR and PLR did not differ significantly. There was no significant difference of investigated biomarkers between survivors and nonsurvivors in trauma patients with and without sepsis except for PLR in the trauma without sepsis subgroup (significantly higher in nonsurvivors, AUC/ROC of 0.719). Independent predictor of lethal outcome was NLR in the whole cohort and in the peritonitis subgroup as well as MPV in the pancreatitis subgroup. Also, there were statistically significant differences in MPV/PC, MLR, and PLR values regarding nature of bacteremia. In general, the lowest levels had been found in patients with Gram-positive blood cultures. Conclusions. NLR and MPV were very good independent predictors of lethal outcome. For the first time, we demonstrate that nature of bacteremia influences MPV/PC, MLR, and PLR. In heterogeneous cohort subgroup, analysis is essential.

scholarly journals The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pattraporn Tajarernmuang ◽  
Arintaya Phrommintikul ◽  
Atikun Limsukon ◽  
Chaicharn Pothirat ◽  
Kaweesak Chittawatanarat
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Meta Analysis ◽  
Small Sample ◽  
Mean Difference ◽  
Platelet Volume ◽  
Significant Difference ◽  
The Mean

Background. An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients.Objective. We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients.Methods. We did electronic search in Medline, Scopus, and Embase up to November 2015.Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38;p=0.112). However, after small sample studies were excluded in sensitivity analysis, the pooling mean difference of MPV was 0.32 (95% CI: 0.04, 0.60;p=0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%.Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.

scholarly journals Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/platelet ratio for 1-year mortality in critically ill patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sung Yeon Ham ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Byung Hwan Yun ◽  
Darhae Eum ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Independent Predictor ◽  
Platelet Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Third ◽  
Survivor Group ◽  
Kaplan Meier

AbstractSeveral studies have reported that the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are associated with poor prognosis. This study investigated whether NLR and/or the MPV/platelet ratio could function as predictive markers of mortality in critically ill patients. We retrospectively reviewed 1,154 patients admitted to the intensive care unit (ICU) between January 2017 and December 2017. Patients were divided into 2 groups according to 1-year mortality. We compared the NLR and MPV/platelet ratio on each day of ICU admission. Patients were classified into tertiles based on their NLR and MPV/platelet ratios, and the incidence of 1-year mortality was compared. Kaplan–Meier survival curves were plotted to evaluate their potential as prognostic factors for 1-year mortality. The NLR and MPV/platelet ratio were higher in the non-survivor group than in the survivor group. The incidence of 1-year mortality was the highest in the third tertile for both the NLR and MPV/platelet ratio. The MPV/platelet ratio was an independent predictor for 1-year mortality based on the Kaplan–Meier survival analysis. Our data showed that the MPV/platelet ratio is a predictive factor for 1-year mortality in critically ill patients.

scholarly journals Association of platelet count and platelet indices with cranial meningioma

2020 ◽  
pp. 123-126
Author(s):  
Yasar Karatas ◽  
Fatih Keskin ◽  
Mehmet Fatih Erdi ◽  
Bulent Kaya ◽  
Densel Arac ◽  
...  
Keyword(s):  
Platelet Count ◽  
Mean Platelet Volume ◽  
Small Sample ◽  
Control Group ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Healthy Group ◽  
Platelet Indices ◽  
Significant Difference

Introduction and Objectives: In this study, we aimed to investigate whether platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width  (PDW) values can be used as diagnostic markers in cranial meningiomas. Materials and Methods: The study included results of 29 patient and 47 healthy contributors. Based on pathologies, the patients were divided into two groups. The first group included meningioma patients and the second one included healthy individuals. Healthy contributors named control group. Platelet count and platelet indices were determined using Sysmex XN 550 haematology analyzer. The preoperative platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width  (PDW) values were recorded from the routine laboratory tests. Results: There was no statistically significant difference in PLT between the meningioma and healthy groups (p = 0.217). There was a statistically significant difference in PCT between the meningioma group and the healthy group (p = 0.002). There was a statistically significant difference in PDW between meningioma group and healthy group (p = 0.001). In terms of MPV, there was a statistically significant difference between meningioma group and the healthy group (p = 0.001) Conclusion: Platelet count and indices are easily available in the routine blood tests. Despite the retrospective design and small sample size, our findings suggest that altered MPV, PDW and PCT levels might serve as potential biomarkers for the diagnosis of meningiomas.

scholarly journals Study of Platelet Indices and Their Interpretation in Thrombocytopenia in a Tertiary Care Hospital

2021 ◽  
Vol 10 (7) ◽  
pp. 435-439
Author(s):  
Vani Mittal ◽  
Munesh Munesh ◽  
Irbinder Kour Bali ◽  
Sunil Arora ◽  
Jyoti Singh ◽  
...  
Keyword(s):  
Platelet Count ◽  
Mean Platelet Volume ◽  
Large Cell ◽  
Care Hospital ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Cell Ratio ◽  
Platelet Indices ◽  
Significant Difference

BACKGROUND Thrombocytopenia may either be due to increased destruction or impaired production of platelets. Platelet count alone is not enough to determine the mechanism of low platelets. Platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and platelet crit (PCT) can help determine the cause and we aimed at finding their role and function in cases of thrombocytopenia. METHODS An observational cross-sectional study of 155 patients with thrombocytopenia and 71 controls was done for a period of six months in SGT Hospital, Gurugram, to determine the mechanism behind the low platelet count with the help of these indices. RESULTS The mean values of the platelet indices (PDW, P-LCR and PCT) were found to be higher in accelerated destruction group (P < 0.05) in comparison to hypoproductive group, whereas, mean MPV values were higher in the former, but was not statistically significant. On comparison with the controls, both the groups of thrombocytopenia showed a statistically significant difference with P < 0.005 in all the four indices. Mean PCT values showed a highly significant difference between the two groups as well as with controls (P < 0.001) and also the relationship of PCT with severity of thrombocytopenia showed a direct relationship which was also significant (P < 0.001). CONCLUSIONS In distinguishing between the cause of thrombocytopenia i.e., hypoproductive or hyper destruction, platelet parameters play an important role. These platelet indices are easily available with the help of automated haematology analysers and can reduce the need for costly and invasive tests for evaluation of thrombocytopenia. KEY WORDS Mean Platelet Volume, Platelet crit, Platelet Distribution Width, Platelet Large Cell Ratio, Thrombocytopenia

Perception of Nurses and Relatives on Family Needs of Critically Ill Patients: A Hospital Based Comparative Study

2020 ◽  
Vol 3 (2) ◽  
pp. 6-13
Author(s):  
Sabita Pandey ◽  
Roshanee Shrestha ◽  
Narayani Paudel
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Family Members ◽  
Holistic Health ◽  
Critically Ill Patient ◽  
Family Needs ◽  
Cross Sectional ◽  
Significant Difference

Background: Critical ill patients are not able to decide about their treatment and their relatives usually asked for the treatment decisions on behalf of the patient. At the time of critical illness, all family members or relatives experience crises and may be exhausted. Recognizing and addressing the relative’s needs is a very important aspect of holistic health care to critically ill patients. Methods: A descriptive cross-sectional study was conducted to make a comparison between the nurses’ and relatives’ perceptions regarding the needs of critically ill patients’ family members’ in the Nepalese context. A convenient sample of 50 nurses and 50 relatives who meet the inclusion criteria were selected and interviewed by using a structured questionnaire in the different intensive care units of Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal during the period of January to April 2018. The data were analyzed by using descriptive and inferential statistics in the statistical package for social sciences version 16. Results: The majority, (86%) of the relatives ranked “to know specific facts concerning the patient’s progress and treatment” as the topmost very important need, and 80% of the nurses’ ranked this need as a very important need. The majority of nurses (86%) ranked “to receive explanations about the environment of critical care unit for the first time” as a topmost very important need, whereas, only 54% of the relatives had ranked this need as very important to them. There was a statically significant positive correlation among some need statements between the two groups. Conclusion: There was a significant difference in the perception of some aspects of family needs by the nurses and relatives. Nurses’ mean score was lower than the relatives’ which can be a major source of disputes among nurses and relatives in the intensive care units. Keywords: Intensive Care Unit, critically ill patient, family needs, nurses’ perception and relatives, perception

scholarly journals Platelet indices evaluation in patients with dengue fever

2018 ◽  
Vol 6 (6) ◽  
pp. 2054 ◽  
Author(s):  
Payal Mukker ◽  
Smitha Kiran
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Mean Platelet Volume ◽  
Dengue Infection ◽  
P Value ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Platelet Indices ◽  
Significant Difference

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

scholarly journals Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Improve Patient Care ◽  
University Hospital ◽  
Treatment Modalities ◽  
Control Group ◽  
Electrolyte Disturbances ◽  
Electrolyte Loss

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.

Sign in / Sign up

Export Citation Format

Share Document