Mean platelet volume as an indicator of persistent organ failure in acute pancreatitis

Aim: Mean platelet volume (MPV) serves as a biomarker of platelet activation. Increased level of MPV is associated with uncontrolled and systemic infection and is correlated to sepsis severity, which is commonly observed in patients with acute pancreatitis (AP). AP patients with persistent organ failure (POF) show an extremely high mortality rate. The association underlying MPV and POF in AP has not been characterized. Methods: We conducted a retrospective cohort study of adult patients who presented within 72 hours from symptom onset of AP at our center between January 2015 and January 2016. Demographic parameters on admission, organ failure assessment, laboratory data and in-hospital mortality were compared between patients with and without POF. Uni-and multi-variate logistic regression analyses were utilized to evaluated the predictive ability of MPV. Results: A total of 156 consecutive AP patients, including 29 with POF, were included. Compared to patients without POF, patients with POF showed a significantly higher value of MPV on admission (11.54 +/- 1.49 vs. 9.68 +/- 1.38 fl; P < 0.001). After multivariate logistic analysis, MPV > 12 fl remained an independent risk factor for POF (Hazard ratio 8.41, 95% confident interval: 1.51-46.77; P = 0.015). A MPV value of 12 fl predicted POF with an area under the curve (AUC) of 0.823, a sensitivity with 44.8% and specificity with 90.6%, respectively. Conclusion: Our results indicate that MPV on admission is independently associated with POF in AP and may serve as a potential prognostic factor.