J Korean Soc Emerg Med.  2020 Apr;31(2):169-180.

Usefulness of serial measurement of the mean platelet volume to predict multipleorgan dysfunction syndrome in patients with severe trauma

Affiliations
  • 1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Emergency Medicine, Graduate School of Medicine, Kangwon National University, Chuncheon, Korea
  • 3Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea

Abstract


Objective
The early prediction of multiple organ dysfunction syndrome (MODS) in trauma patients and provision of prompt treatment may improve their outcomes. We investigated the efficacy of the mean platelet volume (MPV) for predicting MODS in cases of severe trauma.
Methods
This retrospective, observational cohort study was performed with patients prospectively integrated in a critical pathway of TRAUMA. We analyzed the severe trauma patients admitted to the emergency department (ED), based on the Advanced Trauma Life Support guideline, between January 1, 2011 and May 31, 2017. The outcomes were developed from MODS at least 48 hours after ED admission.
Results
A total of 348 patients were enrolled. An increase in the MPV at 12 hours (odds ratio [OR], 2.611; P<0.001) was a strong independent predictor of MODS development. The increasing predictability of MODS was closely associated with an MPV at 12 hours>8.6 fL (OR, 4.831; P<0.001). The area under the receiver operating characteristic curve (AUROC) value of the MPV at 12 hours (0.751; 95% confidence interval [CI], 0.687-0.818; P<0.01) was not inferior than that of Acute Physiology and Chronic Health Evaluation II score, injury severity score, lactate, and total CO2 for predicting MODS.
Conclusion
MPV was an independent predictor of MODS development in severe trauma patients. Emergency physicians can use the MPV as an ancillary biomarker for predicting MODS.

Keyword

Trauma; Multiple organ dysfunction syndrome; Mean platelet volume; Prognosis
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