Mean platelet volume and red blood cell distribution width coefficient of variation as predictors of prognosis in pneumonia in children
DOI:
https://doi.org/10.18203/2349-3291.ijcp20254175Keywords:
Community acquired pneumonia, Mean platelet volume, Red cell distribution widthAbstract
Background: Community acquired pneumonia (CAP) is a major global health concern for children, causing numerous hospitalizations and death. Community acquired pneumonia is a major cause of under-five mortality in children. Identifying reliable prognostic markers is crucial. Mean platelet volume (MPV) and red cell distribution width co-efficient of variation (RDW-CV) are accessible and cost-effective options for assessment of prognosis in pneumonia. This study investigates MPV and RDW-CV as prognostic markers in children with community acquired pneumonia.
Methods: This prospective observational study includes 80 children aged 1-16 years diagnosed with pneumonia upon initial examination and admitted to hospital. Community acquired Pneumonia diagnosis was based on clinical symptoms, physical examination and/or radiological findings. Pneumonia severity was assessed using the Clinical Respiratory Score (CRS), categorizing patients into mild, moderate, severe groups. MPV and RDW-CV were compared among these groups.
Results: Across the sample of 80 children, RDW-CV and MPV values did not demonstrate statistically significant differences when compared by sex, age group, ICU requirement or hospital stay duration. For most comparisons, p-values exceeded 0.05, indicating that variations in these indices are likely due to random fluctuations rather than true biological differences.
Conclusions: Certain trends (higher RDW-CV and MPV in intense severity groups, elevated MPV in pleural effusion and significant ROC for MPV) are biologically plausible in the context of systemic inflammation. MPV appears to be a more reliable marker than RDW-CV in this dataset. RDW-CV did not demonstrate meaningful prognostic value. The findings reinforce that MPV may serve as a supportive, accessible biomarker for predicting more severe pneumonia in children, whereas RDW-CV requires larger sample evaluation to confirm its utility.
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References
Wang Y, Huang X, Li F, Jia X, Jia N, Fu J, et al. Serum-integrated omics reveal the host response landscape for severe pediatric community-acquired pneumonia. Crit Care. 2023;27(1):79. DOI: https://doi.org/10.1186/s13054-023-04378-w
Meyer Sauter PM. Childhood community -acquired pneumonia. Eur J Pediatr. 20204;183(3):1129-36. DOI: https://doi.org/10.1007/s00431-023-05366-6
Ramierz JA. Overview of community-acquired pneumonia in adults. UpToDate, Walth. 2021.
Bartlett JG, Dowell SF, Mandell LA, File TM Jr, Musher DM, Fine MJ. Practice guidelines for the management of community -acquired pneumonia in adults. Infectious Diseases Society of America. Clin infect Dis. 2010;31(2):347-82 DOI: https://doi.org/10.1086/313954
Brar NK, Niederman MS. Management of community -acquired pneumonia: a review and update. Ther Adv Respir Dis. 2011;5(1);61-78. DOI: https://doi.org/10.1177/1753465810381518
Yousef YA, Manal MA. The relationship between level of the red cell distribution width and the outcomes of patients who acquired pneumonia from community. Egyptian J Bronchology. 2019;13(5):738-42. DOI: https://doi.org/10.4103/ejb.ejb_62_19
Bazick HS, Chung D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients. Critical Care Med. 2011;39:1913-21. DOI: https://doi.org/10.1097/CCM.0b013e31821b85c6
Braun E, Domany E, Kenig Y, Mazor Y, Makhol BF, Azzam ZS. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia. Crit Care. 2011;15:194. DOI: https://doi.org/10.1186/cc10355
Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Italian J Pediat. 2013;39(1):16. DOI: https://doi.org/10.1186/1824-7288-39-16
Bath PM, Butterworth RJ. platelet size: measurement, physiology and vascular disease. Blood Coagual Fibrinolysis. 1996;7:157-61. DOI: https://doi.org/10.1097/00001721-199603000-00011
Uysal P, Tuncel T, Olmez D, Babayigit A, Karaman O, Uzner N. The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children. Ann Thorac Med. 2011;6:227-230 DOI: https://doi.org/10.4103/1817-1737.84778
Yuksel O, Helvaci K, Basar O, Koklun S, Caner S, Helvaci N, Abayli E, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20:277-81. DOI: https://doi.org/10.1080/09537100902856781
Yazici S, Yazici M, Erer B, Calik Y, Ozhan H, Ataoglu S. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets. 2010;21:122-5. DOI: https://doi.org/10.3109/09537100903474373
Qi X, Dong Y, Lin X, Xin W. Value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and red blood cell distribution width in evaluating the prognosis of children with severe pneumonia. Evid Based complement Alternat Med. 2021;18:18469. DOI: https://doi.org/10.1155/2021/1818469
Kazerani M, Moghadamniya F. Survey of relationship between platelet count and complications community acquired pneumonia in teaching hospitals of Mashhad Islamic Azad University Med J Mashhad Univ Med Sci. 2014;59(5):302-10.
Golcuk Y, Golcuk B, Bilge A, Irik M, Dikmen O. Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community -acquired pneumonia. Am J Emerg Med. 2015;33(5):648-52. DOI: https://doi.org/10.1016/j.ajem.2015.02.001
Farghly S, Abd-Elkader R, EI Zohne RA, Abd EI-Kareem DM. Mean platelet volume change (MPV) and red blood cell distribution width (RDW) as promising markers of community -acquired pneumonia (CAP)outcome.The Egyptian J Bronchol. 2020;14:1-8. DOI: https://doi.org/10.1186/s43168-020-00024-z
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