Platelet Indices in the Diagnosis of Ventriculoperitoneal Shunt Infection in Children

AIM: Ventriculoperitoneal shunt infection (VPSI) is one of the main causes of mortality and morbidity in hydrocephalus. Platelet indices, mean platelet volume (MPV) and platelet distribution width (PDW) have been evaluated for some infectious diseases. In this study we aimed to investigate whether MPV and PDW values are decisive for the diagnosis of VPSI in children. MATERIAL and METHODS: Charts of VPSI from 2012 to 2015 were reviewed retrospectively. Twenty-five ventriculoperitoneal shunt infected patients and 25 healthy children as the control group were included in the study. Platelet indices were recorded. RESULTS: A total of 25 VPSI patients and 25 healthy children were enrolled in the study. Significant differences were detected between the MPV and PDW values in the two groups (p<0.001). ROC curve analysis suggested a cut off point for MPV as below 9.2 fl (smaller values indicate patients) for the diagnosis of VPSI, with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 80%, 92%, 91% and 82%, respectively. For PDW, the cut-off point was 12.25 (larger values indicate pathology) for diagnosis of VPSI, with sensitivity, specificity, PPV and NPV of 68%, 80%, 77% and 71%, respectively. CONCLUSION: Our results suggest that MPV and PDW can be used for the diagnosis of VPSI in children with an accuracy of at least 75%. Moreover, MPV's specificity is higher than the other platelet parameters and leucocyte count. KEYWORDS: Ventriculoperitoneal shunt infection, Platelet indices, MPV, PDW