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      The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review

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          Abstract

          Platelet indices (PI) — plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW) — are a group of derived platelet parameters obtained as a part of the automatic complete blood count. Emerging evidence suggests that PIs may have diagnostic and prognostic value in certain diseases. This study aimed to summarize the current scientific knowledge on the potential role of PIs as a diagnostic and prognostic marker in patients having emergency, non-traumatic abdominal surgery. In December 2015, we searched Medline/PubMed, Scopus and Google Scholar to identify all articles on PIs. Overall, considerable evidence suggests that PIs are altered with acute appendicitis. Although the role of PI in the differential diagnosis of acute abdomen remains uncertain, low MPV might be useful in acute appendicitis and acute mesenteric ischemia, with high MPV predicting poor prognosis in acute mesenteric ischemia. The current lack of consistency and technical standards in studies involving PIs should be regarded as a serious limitation to comparing these studies. Further large, multicentre prospective studies concurrently collecting data from different ethnicities and genders are needed before they can be used in routine clinical practice.

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          Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management.

          Aneel Bhangu, Kjetil Søreide, Salomone Di Saverio … (2015)
          Acute appendicitis is one of the most common abdominal emergencies worldwide. The cause remains poorly understood, with few advances in the past few decades. To obtain a confident preoperative diagnosis is still a challenge, since the possibility of appendicitis must be entertained in any patient presenting with an acute abdomen. Although biomarkers and imaging are valuable adjuncts to history and examination, their limitations mean that clinical assessment is still the mainstay of diagnosis. A clinical classification is used to stratify management based on simple (non-perforated) and complex (gangrenous or perforated) inflammation, although many patients remain with an equivocal diagnosis, which is one of the most challenging dilemmas. An observed divide in disease course suggests that some cases of simple appendicitis might be self-limiting or respond to antibiotics alone, whereas another type often seems to perforate before the patient reaches hospital. Although the mortality rate is low, postoperative complications are common in complex disease. We discuss existing knowledge in pathogenesis, modern diagnosis, and evolving strategies in management that are leading to stratified care for patients.
          Article 0 comments Cited 330 times – based on 0 reviews     Review now
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            Platelet secretion: From haemostasis to wound healing and beyond

            Ewelina M. Golebiewska, Alastair Poole (2015)
            Upon activation, platelets secrete more than 300 active substances from their intracellular granules. Platelet dense granule components, such as ADP and polyphosphates, contribute to haemostasis and coagulation, but also play a role in cancer metastasis. α-Granules contain multiple cytokines, mitogens, pro- and anti-inflammatory factors and other bioactive molecules that are essential regulators in the complex microenvironment of the growing thrombus but also contribute to a number of disease processes. Our understanding of the molecular mechanisms of secretion and the genetic regulation of granule biogenesis still remains incomplete. In this review we summarise our current understanding of the roles of platelet secretion in health and disease, and discuss some of the hypotheses that may explain how platelets may control the release of its many secreted components in a context-specific manner, to allow platelets to play multiple roles in health and disease.
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              Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis.

              S Chu, R Becker, P Berger … (2010)
              To determine whether an association exists between mean platelet volume (MPV) and acute myocardial infarction (AMI) and other cardiovascular events. Platelet activity is a major culprit in atherothrombotic events. MPV, which is widely available in clinical practice, is a potentially useful biomarker of platelet activity in the setting of cardiovascular disease. We performed a systematic review and meta-analysis investigating the association between MPV and AMI, all-cause mortality following myocardial infarction, and restenosis following coronary angioplasty. Results were pooled using random-effects modeling. Pooled results from 16 cross-sectional studies involving 2809 patients investigating the association of MPV and AMI indicated that MPV was significantly higher in those with AMI than those without AMI [mean difference 0.92 fL, 95% confidence interval (CI) 0.67-1.16, P < 0.001). In subgroup analyses, significant differences in MPV existed between subjects with AMI, subjects with stable coronary disease (P < 0.001), and stable controls (P < 0.001), but not vs. those with unstable angina (P = 0.24). Pooled results from three cohort studies involving 3184 patients evaluating the risk of death following AMI demonstrated that an elevated MPV increased the odds of death as compared with a normal MPV (11.5% vs. 7.1%, odds ratio 1.65, 95% CI 1.12-2.52, P = 0.012). Pooled results from five cohort studies involving 430 patients who underwent coronary angioplasty revealed that MPV was significantly higher in patients who developed restenosis than in those who did not develop restenosis (mean difference 0.98 fL, 95% CI 0.74-1.21, P < 0.001). Elevated MPV is associated with AMI, mortality following myocardial infarction, and restenosis following coronary angioplasty. These data suggest that MPV is a potentially useful prognostic biomarker in patients with cardiovascular disease. Whether the relationship is causal, and whether MPV should influence practice or guide therapy, remains unknown.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Biochem Med (Zagreb)
                Journal ID (iso-abbrev): Biochem Med (Zagreb)
                Journal ID (publisher-id): BM
                Title: Biochemia Medica
                Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
                ISSN (Print): 1330-0962
                ISSN (Electronic): 1846-7482
                Publication date (Print and electronic): 10 June 2016
                Publication date (Electronic): 10 June 2016
                Publication date (Print): 10 June 2016
                Volume: 26
                Issue: 2
                Pages: 178-193
                Affiliations
                [1 ]Department of Clinical Chemistry, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
                [2 ]Department of General Surgery, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
                Author notes
                Article
                Publisher ID: bm-26-178
                DOI: 10.11613/BM.2016.020
                PMC ID: 4910273
                PubMed ID: 27346963
                SO-VID: a9f14adf-2e42-4dfc-8c6f-f0aaa3caef48
                Copyright statement: Copyright @ 2016
                History
                Date received : 25 November 2015
                Date accepted : 28 February 2016
                Categories
                Subject: Review

                Keywords: platelets,acute appendicitis,acute cholecystitis,acute mesenteric ischemia,platelet indices
                Data availability:
                Keywords: platelets, acute appendicitis, acute cholecystitis, acute mesenteric ischemia, platelet indices

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