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논문분류	춘계학술대회 초록집
제목	An Increase in Mean Platelet Volume from Baseline is Associated with Mortality in Patients with Severe Sepsis or Septic Shock
저자	Young Su Joo, Chan Ho Kim, Youn Kyung Kee, Chang-Yun Yoon, Eunyoung Lee,In Mee Han, Seung Gyu Han, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo
출판정보	2014; 2014(1):
키워드	평균 혈소판 용적 변화, 사망률, 중증 패혈증
초록	Background: Mean platelet volume (MPV) is suggested as an index of inflammation and disease activity in addition to reflecting the efficacy of anti-inflammatory treatment in chronic inflammatory disorder patients. However, the prognostic value of MPV on mortality remains unclear in patients with severe sepsis. Methods: We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between Nov. 2007 and Dec. 2011. The change in MPV between hospital admission and 72 hours after treatment (ΔMPV72h-adm) was evaluated as a prognostic factor for 28-day mortality. Linear mixed model and Cox proportional hazards analysis were used. Results: The mean age of the enrolled patients was 64.2±15.7 years, 169 (49.0%) of them were males. Thirty-five (10.1%) patients died within 28 days after ED admission. During the first 72 hrs of ED admission, MPV significantly increased in both non-survivors (p=0.001) and survivors (p<0.001) compared to baseline. ΔMPV72h-adm was significantly higher, in non-survivors compared to survivors (p=0.003). However, the change in the number of platelets over the first 72 hours did not differ significantly between the two groups (p=0.360). Multivariate analysis revealed that ΔMPV72h-adm was an independent predictor of 28-day mortality, even after adjusting for age, sex, body mass index, Sequential Organ Failure Assessment scores, renal replacement therapy, platelet count, C-reactive protein levels, albumin levels, and lactate levels (hazard ratio, 1.44; 95% confidence interval, 1.01-2.06; p=0.044). Conclusions: An increase in MPV during the first 72 hours of hospitalization could be an independent risk factor for adverse clinical outcomes in severe sepsis. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.
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