The Value Of Platelet Distribution Width In Evaluating The Prognosis Of Septic DIC Patients

Objective: Sepsis is frequently complicated by disseminated intravascular coagulation(DIC)in which platelet activation has been proved to be an important pathogenesis.Platelet distribution width(PDW)is a regular marker for platelet activation.This study aimed to investigate the clinical value of platelet distribution width in early evaluation of the prognosis of patients with septic DIC.Methods: Data from 59 consecutive adult patients with septic DIC admitted from January 2016 to December 2016 in Intensive Care Unit of the First Affiliated Hospital of China Medical University,current information is based on retrospective studies.All patients were divided into death group and survival group.We compared the platelet count(PLT),platelet distribution width(PDW)and the ratio of PDW/ PLT to find out if there were any difference between two groups.Receiver operating curve(ROC)analysis was performed to estimate the value of PLT,PDW and PDW/PLT ratio,in terms of the prognosis of patient with septic DIC.Results: Consecutive 59 eligible patients over a period from January 2016 through December 2016 were included among which 30 patients were men and the others were women.The average age was 61.84 ±16.83(22 ~ 88 years).Of those 33 survived and 26 died.The mean age for survivors was 56.67±19.01(22 ~ 83 years),and 68.42 ±10.70(52~ 87 years)for those who died.The mean APACHEII score and SOFA score were 14.51±4.87 and 6.55±2.56 for the survival group,which were significantly lower than those in the dead group(18.94±7.78 and 8.81 ±3.54,p < 0.05)respectively.The mean PLT,PDW and PDW/PLT ratio of the survival group at the diagnosis of DIC were 177.33 ± 96.14,12.76 ±2.47 and 2.47 ± 0.09,respectively.In the meanwhile,the mean PLT,PDW and PDW/PLT ratio of the dead group were 125.81 ±87.43,14.50 ±3.12 and 3.12 ± 0.53,respectively.There were significant differences between the two groups(p value were0.038,0.02 and 0.038,respectively).Receiver operating curve(ROC)analysis was performed to assess those parameters among the 26 patients who died.The area under the receiver operating curve(ROC)for PLT,PDW,PDW/PLT ratio,APACHE II score and SOFA score were 0.321,0.699,0.755,0.713 and 0.693 respectively.The ratio of PDW/PLT had the best prediction value for prognosis of septic DIC.When the ratio of PDW/PLT exceeded 0.12,the sensitivity for predicting prognosis of septic DIC was 65.4% with the specificity of 78.8%.Conclusion: The septic DIC patients had decreased PLT count,increased PDW and the ratio of PDW/PLT,which were more severe for the dead patients.The PDW level and the ratio of PDW/PLT had certain value in predicting the prognosis of septic DIC patients and the ratio of PDW/PLT was better than the PDW level alone.