Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia
No Thumbnail Available
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Objective: This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, > 65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). Methods: This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results: A total of 174 patients (mean age, 66.7 ± 15.8 years; 66.1% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 16.1%. A significant and inverse correlation between MPV and CURB-65 score was found (R = -.58, P <.001). We determined that the optimal MPV cutoff for predicting 28-day mortality at the time of ED admission was 8.55 fL, with a 75.0% sensitivity and a 75.3% specificity. For the prediction of 28-day mortality, the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI], 0.740-0.898; P <.001) when the CURB-65 score was used alone, whereas it increased to 0.895 (95% CI, 0.819-0.936; P <.001) with the addition of MPV to the score. Conclusions: Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality. © 2015 Elsevier Inc.
Description
Keywords
Aged , Cause of Death , Community-Acquired Infections , Cross-Sectional Studies , Emergency Service, Hospital , Female , Hospital Mortality , Humans , Male , Mean Platelet Volume , Pneumonia , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity , Severity of Illness Index , Turkey , aged , Article , artificial ventilation , blood cell count , body temperature , breathing rate , community acquired pneumonia , confusion , cross-sectional study , CURB 65 score , diastolic blood pressure , emergency ward , female , follow up , hemodynamic parameters , hospital admission , human , major clinical study , male , medical history , mortality , observational study , oxygen saturation , priority journal , prospective study , respiratory tract disease assessment , systolic blood pressure , thrombocyte volume , blood , cause of death , community acquired infection , emergency health service , epidemiology , pneumonia , predictive value , sensitivity and specificity , severity of illness index , Turkey