Diagnostic and prognostic value of the ratio of mean platelet volume to platelet count in acute mesenteric ischemia

Year 2022, Volume: 5 Issue: 2, 682 - 688, 15.03.2022

Murat Bulut Özkan , Ramazan Topcu , Fatih Şahin , Murat Baki Yıldırım

https://doi.org/10.32322/jhsm.1076082

Abstract

Introduction: Acute mesenteric ischemia (AMI) is a condition in which there is a sudden cessation of blood supply to a particular intestinal segment and consequent cellular damage. Although it has a low incidence of approximately 0.09-0.2% of all emergency surgery admissions, AMI is a severe condition that can cause high early mortality. A direct relationship between an increased mean platelet volume (MPV) and acute thrombotic events has been shown in recent years. we aimed to find out whether the diagnosis of mesenteric ischemia and the amount of bowel segment affected by ischemia will guide clinicians preoperatively with these markers
Material and Method: A total of 57 cases with bowel resection due to mesenteric ischemia were included in the study. The gender, age, serum platelet (PLT), MPV, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), Albumin, CRP, neutrophil-lymphocyte ratio (NLR), MPV/Platelet Count, and CRP-albumin ratio (CAR) levels at the time of admission, operation time, length of resected bowel segment, length of hospital stay, presence of necrosis and perforation from pathology reports, and length of bowel segment leading to necrosis were scanned.
Results: A moderate (moderate) negative correlation was found between the length of resected bowel segment and PLT (P<0.001; r=-0.685). A moderate positive significant correlation was found between resection length and MPV (P<0.001; r=0.565). A high significant positive correlation was found between resection length and MPV/PC (P<0.001; r=0.857). PLT, WBC and MPV/PC values were statistically different between the perforated group and no-perforation group (p=0.009, p=0.024, p=0.010). WBC and MPV/PC values were significantly higher in the perforated group.
Conclusion: MPV/PC and PLT value at hospital admission is a reliable and simple predictive factor in determining perforation and the amount of bowel segment affected in patients with acute mesenteric ischemia.

Keywords

acute mesenteric ischemia, bowel necrosis, mean platelet volume, platelet indices

References

• Patel A, Kaleya RN, Sammartano RJ. Pathophysiology of mesenteric ischemia. Surg Clin North Am 1992; 72: 31-41.
• Corcos O, Castier Y, Sibert A, et al. Effects of a multimodal management strategy for acute mesenteric ischemia on survival and intestinal failure. Clin Gastroenterol Hepatol 2013; 11: 158-65 e2.
• Canfora A, Ferronetti A, Marte G, et al. Predictive factors of intestinal necrosis in acute mesenteric ischemia. Open Med (Wars) 2019; 14: 883-9.
• Ichiba T, Hara M, Yunoki K, et al. Baseline disease is a more important predictor of intestinal necrosis than CT findings in patients with acute mesenteric ischemia. Am J Emerg Med 2016; 34: 2261-5.
• Clair DG, Beach JM. Mesenteric Ischemia. N Engl J Med 2016; 374: 959-68.
• Eldrup-Jorgensen J, Hawkins RE, Bredenberg CE. Abdominal vascular catastrophes. Surg Clin North Am 1997; 77: 1305-20.
• Tsai CJ, Kuo YC, Chen PC, et al. The spectrum of acute intestinal vascular failure: a collective review of 43 cases in Taiwan. Br J Clin Pract 1990; 44: 603-8.
• Sahin M, Bulus H, Yavuz A, et al. The role of the lactate level in determining the risk rates of small bowel resection in incarcerated hernias. Ulus Travma Acil Cerrahi Derg 2020; 26: 593-9.
• Augene E, Lareyre F, Chikande J, et al. Platelet to lymphocyte ratio as a predictive factor of 30-day mortality in patients with acute mesenteric ischemia. PLoS One 2019; 14: e0219763.
• Kantekin B, Avcil M, Kapçı M, et al. Are the blood urea nitrogen/creatinine ratio and the mean platelet volume able to act as predictors of mortality and morbidity in patients with upper gastrointestinal bleeding?. Anatolian Curr Med J 2021; 3: 274-8.
• Türkoğlu A, Gül M, Oğuz A, et al. Mean platelet volume: is it a predictive parameter in diagnosis of acute mesenteric ischemia? Int Surg 2015; 100: 962-5.
• Altintoprak F, Arslan Y, Yalkin O, et al. Mean platelet volume as a potential prognostic marker in patients with acute mesenteric ischemia-retrospective study. World J Emerg Surg 2013; 8: 49.
• Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001; 22: 1561-71.
• Amraotkar AR, Song DD, Otero D, et al. Platelet count and mean platelet volume at the time of and after acute myocardial infarction. Clin Appl Thromb Hemost 2017; 23: 1052-9.
• Wasilewski J, Desperak P, Hawranek M, et al. Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study. Platelets 2016; 27: 452-8.
• Sabença F, Carvalho A, Rocha M, et al. Mean platelet volume and mechanical thrombectomy. J Stroke Cerebrovasc Dis 2020; 29: 104971.
• Rief P, Raggam RB, Avian A, et al. Low mean platelet volume is associated with critical limb ischemia in peripheral arterial occlusive disease. Sci Rep 2018; 8: 6718.
• Rachmanadi MB, Ismail MT, Anggraeni VY. Relationship between mean platelet volume and critical limb ischemia in diabetes mellitus patients. Int J Angiol 2021; 30: 257-61.
• Akar M. Is mean platelet volume better than other long-used non-invasive parameters in assessing severe fibrosis in patients with chronic hepatitis B?. J Health Sci Med 2021; 4: 96-102.
• Kamış F , Çetin E , Ugar M , et al. Ülseratif kolitte hastalık aktivitesini değerlendirmede ortalama trombosit hacmi ile nötrofil-lenfosit oranı ve platelet-lenfosit oranlarının değerlendirilmesi. J Med Palliat Care 2020; 1: 28-33.
• Turhan VB, Ünsal A, Gök HF, et al. Predictive value of preoperative neutrophil-lymphocyte and platelet-lymphocyte ratio in determining the stage of colon tumors. Cureus 2021; 13: e18381.
• Wu YY, Zhang X, Qin YY, Qin JQ, Lin FQ. Mean platelet volume/platelet count ratio in colorectal cancer: a retrospective clinical study. BMC Cancer 2019; 19: 314.
• Panigada M, Bottino N, Tagliabue P, et al. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost 2020; 18: 1738-2.
• Yantiss RK, Qin L, He B, et al. Intestinal abnormalities in patients with SARS-CoV-2 infection: histopathologic changes reflect mechanisms of disease. Am J Surg Pathol 2022; 46: 89-96.
• Serban D, Tribus LC, Vancea G, et al. Acute mesenteric ischemia in COVID-19 Patients. J Clin Med 2021; 11: 200.