Background

Aneurysmal subarachnoid hemorrhage (aSAH) is both a hypercoagulable and inflammation state in which many biomarkers have been studied. Activated platelets have been identified to be of clinical importance in thrombosis and neuroinflammation after aSAH. The aim of this study was to investigate the relationship between mean platelet volume (MPV) to platelet count (PC) ratio, a surrogate parameter for activated platelets, and the functional outcome in aSAH patients.

Methods

A retrospective analysis was performed of patients with aSAH admitted to the stroke center of our institution between November 2018 and November 2019. The mean MPV/PC ratio during the first three days after aSAH onset was calculated. Poor outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months. Receive operating characteristic (ROC) curve analysis was performed to determine the optimal value of MPV/PC ratio for the prediction of poor outcome in patients with aSAH.

Results

A total of 100 patients were included, 13 (13.0%) died and 35 (35.0%) had a poor outcome. Mean MPV/PC ratio (P < 0.001) when measured over the study period, was significantly higher among patients with poor outcome. In multivariable analysis, increased mean MPV/PC ratio was associated with poor functional outcome at 3 months (odds ratio (OR) = 1.94; 95% confidence interval (CI): 1.19-3.17; P = 0.008). The optimal cutoff of MPV/PC ratio for predicting poor outcome at 3 months was 6.77 (sensitivity 74.3%, specificity 61.5%).

Conclusion

An increased MPV/PC ratio is associated with poor functional outcome in aSAH patients. MPV/PC ratio may be a useful predictor of outcome after aSAH.

中文翻译：

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平均血小板体积/血小板计数比与动脉瘤性蛛网膜下腔出血后不良的临床结果相关

背景

动脉瘤性蛛网膜下腔出血（aSAH）既是高凝状态又是炎症状态，其中许多生物标志物已被研究。已确认活化的血小板在aSAH后对血栓形成和神经炎症具有临床重要性。这项研究的目的是调查aSAH患者的平均血小板体积（MPV）与血小板计数（PC）比率，活化血小板的替代参数以及功能结局之间的关系。

方法

回顾性分析2018年11月至2019年11月间在我院卒中中心住院的aSAH患者。计算aSAH发作后前三天的平均MPV / PC比。不良结局定义为3个月时改良的Rankin量表（mRS）评分为3-6。进行接收操作特征（ROC）曲线分析以确定MPV / PC比的最佳值，以预测aSAH患者的不良预后。

结果

包括100例患者，其中13例（13.0％）死亡，35例（35.0％）不良预后。在研究期间测量的平均MPV / PC比（P <0.001）在结局较差的患者中明显更高。在多变量分析中，MPV / PC平均比值升高与3个月时的功能预后不良相关（比值比（OR）= 1.94； 95％置信区间（CI）：1.19-3.17；P  = 0.008）。预测3个月预后不良的MPV / PC比的最佳截止值为6.77（敏感性74.3％，特异性61.5％）。

结论

MPV / PC比升高与aSAH患者的功能预后不良相关。MPV / PC比可能是aSAH后结局的有用预测指标。