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. 2018 Nov 9:14:2221-2228.
doi: 10.2147/TCRM.S181381. eCollection 2018.

Complex calculation or quick glance? Mean platelet volume - new predictive marker for pulmonary embolism

Anna Lipinska  1 , Anna Ledakowicz-Polak  1 , Grzegorz Krauza  1 , Katarzyna Przybylak  1 , Marzenna Zielinska  1
Affiliations

Complex calculation or quick glance? Mean platelet volume - new predictive marker for pulmonary embolism

Anna Lipinska et al. Ther Clin Risk Manag. .

Abstract

Background: Wells and Geneva scores are widely used in the assessment of pretest probability of pulmonary embolism (PE).

Objective: The objective of this study was to examine the hypothesis that mean platelet volume (MPV) may better predict PE than the clinical prediction rules.

Methods: A study was performed among patients with PE. Baseline characteristics and complete blood counts including MPV were prospectively recorded upon admission. To assess clinical probability in patients with PE risk, we used Wells and Geneva scores.

Results: Data records of 136 patients (males: 44%) with median age of 66 years (interquartile range [IQR] 57.5-78.0) diagnosed with PE at the Intensive Cardiac Therapy Clinic in Lodz (Poland) were analyzed. Baseline characteristics indicate that patients suffered from arterial hypertension (65%), obesity (32%), and diabetes mellitus (24%). Furthermore, they reported active smoking (21%), prolonged immobilization (20%), major surgery (21%), pregnancy (4%), and oral contraceptives (9%). Patients presented with various symptoms. The MPV, plateletcrit, and D-dimer values on admission were respectively as follows: 10.71 (IQR 3.29-13.67), 0.2 (IQR 0.15-0.24), and 9.23 (IQR 8.5-9.85). The study revealed that Wells score correlated significantly with an elevated MPV value (P<0.05) per contra to Geneva score (P>0.05). According to our results, there is a lack of coherence between Wells and Geneva scores (P>0.05). Finally, we determined that the optimum MPV level cutoff point for PE on admission with reference to the original Wells score is 9.6 fL.

Conclusion: MPV may be considered useful as an adjunctive or independent predictive marker for PE used in lieu of clinical prediction rules.

Keywords: Geneva score; Wells score; mean platelet volume; pulmonary embolism.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Correlation between mean platelet volume value and (A) Wells rule (original version), (B) Wells rule (simplified version), and (C) revised Geneva score (original version). Abbreviation: MPV, mean platelet volume.
Figure 2
Figure 2
The distribution of (A) Wells scores (original version), (B) Wells scores (simplified version), and (C) revised Geneva scores (original version) in patients with pulmonary embolism.
Figure 3
Figure 3
Receiver operating characteristic curve and the optimal cutoff point of MPV (9.6 fL) for pulmonary embolism at admission with reference to the original Wells score (area under curve: 0.73; sensitivity: 69.2%; specificity: 71.8%; Youden’s index: 0.41). Abbreviation: MPV, mean platelet volume.
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