Therefore, we aimed to compare demographic, clinical, laboratory and radiographic characteristics, as well as short- and long-term outcomes of patients hospitalized for CAP, according to changes in MPV. The clinical characteristics and prognosis of time-dependent MPV changes have not been investigated in the CAP population. The prognostic significance of MPV has been reported in only two small studies on CAP patients, which were based on single MPV determinations. Patients hospitalized with community-acquired pneumonia (CAP) are at an increased risk of death in the hospital and following discharge. In a number of studies consisting of patients with critical illness, bacteremia, coronary artery disease and heterogeneous disorders, a rise in MPV over time was identified as a powerful predictor of morbidity and mortality. Moreover, MPV is a dynamic parameter that may change significantly within several days or weeks. A single measurement of elevated MPV has been reported to be associated with increased morbidity and mortality in various patient populations. Mean platelet volume (MPV) is a routine laboratory test that is measured in complete blood count and considered a marker of platelet function and activation. Platelets play an important role in processes of hemostasis, inflammation and immunity. A rise in MPV strongly predicts in-hospital and long-term mortality. Rising MPV during hospitalization for CAP is associated with a more severe clinical profile than no rise in MPV. A rise in MPV was a powerful predictor of all-cause mortality (relative risk 1.26 and 95% confidence interval 1.11–1.43). The respective 90-day, 3-year and total (median follow-up of 54 months) mortality rates were significantly higher in group B (29.1%, 43.0% and 50.0%) than group A (7.3%, 24.2% and 32.6%), p < 0.001 for all comparisons. Rising MPV strongly predicted a need for mechanical ventilation and in-hospital death (the respective relative risks: 2.62 and 6.79 95% confidence intervals: 1.54–4.45 and 3.48–13.20). On discharge, lower values of platelets and higher levels of neutrophils were observed in group B. Patients with a rise in MPV were more likely to be older, and to present with renal dysfunction, cerebrovascular disorder and severe pneumonia than were patients with no rise in MPV. Groups A and B comprised 83.8% and 16.2% of patients, respectively.
MethodsĪmong 976 adults hospitalized for CAP, clinical characteristics, in-hospital outcomes (transfer to the intensive care unit, treatment with mechanical ventilation, prolonged hospital stay and death), and all-cause mortality following discharge, were compared according to ΔMPV (MPV on discharge minus MPV on admission): groups A (no rising MPV, ΔMPV < 0.6 fL) and B (rising MPV, ΔMPV ≥ 0.6 fL). Clinical characteristics and the prognostic significance of changes in mean platelet volume (MPV) during hospitalization for community-acquired pneumonia (CAP) have not been investigated.
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