• Geun Ho Oh, Sung Phil Chung, Yoo Seok Park, Jung Hwa Hong, Hye Sun Lee, Hyun Soo Chung, Je Sung You, Jong Woo Park, and Incheol Park.
• *Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea †Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea ‡Department of Emergency Medicine, Kosin University College of Medicine, Busan, Republic of Korea.
• Shock. 2017 Mar 1; 47 (3): 323-330.

PurposeWe evaluated the mean platelet volume (MPV) to platelet ratio to determine its significance as a prognostic marker for early mortality in critically ill patients with suspected sepsis receiving early goal-directed therapy (EGDT).MethodsWe retrospectively reviewed the records from a prospective EGDT registry and screened eligible adult patients who were admitted to the emergency department (ED) with severe sepsis and/or septic shock. The MPV/platelet ratio was estimated as the MPV value divided by the platelet count on each day of hospitalization. The clinical outcome was 28-day mortality.ResultsWe included 120 patients receiving EGDT. In the multivariate Cox proportional hazard models, higher MPV/platelet ratios on admission (HR: 1.04; 95% CI: 1.015-1.066; P = 0.002) and at 24 h (HR: 1.032; 95% CI: 1.012-1.054; P = 0.002) were significant risk factors for mortality at 28 days. An increased trend for 28-day mortality was associated with a MPV/platelet ratio >3.71 on admission (HR: 4.274; 95% CI: 1.228-14.874; P = 0.023) and a higher MPV/platelet ratio (>6.49) at 24 h (HR: 2.719; 95% CI: 1.048-7.051; P = 0.04) in patients with severe sepsis receiving EGDT.ConclusionIn our study, MPV or platelet count alone did not predict shock and 28-day mortality in patients with severe sepsis receiving EGDT. However, the MPV/platelet ratio at ED admission and on day 1 is a promising prognostic marker for 28-day mortality in patients with severe sepsis.

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