Background: Sepsis is defined as the presence (probable or documented) of infection together with systemic manifestations of infection. Severe sepsis is defined as sepsis plus sepsis-induced organ dysfunction or tissue hypo-perfusion. Mean platelet volume (MPV) is a machine-calculated measurement of the average size of platelets found in blood and is typically included in blood tests as part of the CBC. It is considered as an indirect marker for acute thrombocytopenia. This study aims to look at the response of Mean Platelet Volume in severe sepsis and its capability in prognostication with an initial value.

Objective:To assess the association between Mean Platelet Volume (MPV) on Day 1 of ICU admission and the outcome in patients with Severe Sepsis admitted in Medical ICU of Govt. T D Medical College, Alappuzha

Materials and Methods:It is a prospective observational study of 1 year duration. All patients with severe sepsis admitted in Medical ICU of Govt. T D Medical College, Alappuzha during the study period, who met the inclusion and exclusion criteria were taken as study subjects. Patients were divided according to their outcome into Expired and Shift out category of equal numbers. The total sample size of the study is 300. Data obtained were analyzed using SPSS20.

Results: Out of 300 patients who were selected after passing through the inclusion and exclusion criteria, 195 were male and 105 female patients. The most common reason for admission was Pneumonia (110 patients) followed by Leptospirosis (70 patients). There was no significant difference in the gender and mean age between Expired and Shift out category. There was a significant difference in MPV Day 1 between Expired and Shift out groups with a t value of 3.92 and a p<0.01. Also there was a significant difference in Highest MPV between Expired and Shift out groups with a t value of 4.37 and a p<0.01. The MPV day 1 and Highest MPV were significantly higher in Expired group compared to Shift outgroup.

Conclusion: Mean Platelet Volume, which is a part and parcel of a Complete Blood Count, is a hidden gem in our diagnostic panel which can help us to identify a patient with a possibly poor outcome on admission. A high MPV on admission to the ICU with severe Sepsis, suggests a higher chance of mortality during ICU stay.

Key words: Severe sepsis; Mean Platelet Volume (MPV); Platelets; Thrombocytopenia; Expired, Shift out.

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Rahul P N

Junior Resident, Department of General Medicine

Govt.TD Medical College,Alappuzha,Kerala, India

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