Value of mean plalett volume (mpv) and its variability as predictors of septic shock in patients with bacteriaemia

Abstract

Objective: Analyze absolute values and variations of MPV in patients with bacteremia to assess the prognostic value for progression to septic shock.

Materials and Methods: Analytic-descriptive, longitudinal, observational, retrospective, and single-center study. Ninety patients with bacteremia admitted to the Hospital Provincial del Centenario were evaluated over four de"ned periods relative to blood culture collection: 0 (30-3 days prior, if available), 1 (within 24 hours), 2 (48-72 hours), and 3 (5-8 days). Non-parametric tests, Chi-square, or Fisher’s Exact Test were used as appropriate. Multivariate Binary Logistic Regression and ROC curve analyses were conducted. OR and 95% CI are reported. Approved by the Ethics Committee.

Results: MPV signi"cantly increased in patients who developed septic shock (24.4%, n=22) from period 2 onwards (p=0.017). Analyzing MPV changes between blood culture collection and the available previous value (Delta MPV 1-0) yielded an AUC of 0.73 via ROC curve. Two cuto! points were established: ≥0 fL (p=0.012, sensitivity 83.30%, speci"city 51.20%, OR 5.24 (1.32–20.74)) and ≥1 fL (p=0.011, sensitivity 38.90%, speci"city 90.66%, OR 6.21 (1.53–25.13)). After Logistic Regression, Delta MPV 1-0 remained statistically signi"cant when adjusting for other septic shock predictors (p=0.004, OR 4.10 (1.58–10.65)).

Conclusion: Routinely reported in complete blood counts, MPV is universally available and does not increase the cost of care. It could be useful to enhance monitoring frequency in bacteremia patients with positivity in this parameter.