1
|
Zou S, Mohtar SH, Othman R, Hassan RM, Liang K, Lei D, Xu B. Platelet distribution width as an useful indicator of influenza severity in children. BMC Infect Dis 2024; 24:9. [PMID: 38166827 PMCID: PMC10759456 DOI: 10.1186/s12879-023-08890-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The present study aims to investigate the potential of platelet distribution width as an useful parameter to assess the severity of influenza in children. METHODS Baseline characteristics and laboratory results were collected and analyzed. Receiver operating characteristic (ROC) curve analysis was used to joint detection of inflammatory markers for influenza positive children, and the scatter-dot plots were used to compare the differences between severe and non-severe group. RESULTS Influenza B positive children had more bronchitis and pneumonia (P < 0.05), influenza A infected children had more other serious symptoms (P = 0.007). Neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), and platelet parameters performed differently among < 4 years and ≥ 4 years children with influenza. Combined detection of platelet parameters and other indicators could better separate healthy children from influenza infected children than single indicator detection. The levels of platelet distribution width of children with severe influenza (A and B) infection was significantly dropped, compared with non-severe group (P < 0.05). CONCLUSIONS Platelet distribution width could be a very useful and economic indicator in distinction and severity assessment for children with influenza.
Collapse
Affiliation(s)
- Seyin Zou
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China.
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia.
| | - Siti Hasmah Mohtar
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia.
| | - Roshani Othman
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia
| | - Rodiah Mohd Hassan
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia
| | - Kun Liang
- Guangdong Medical University, Dongguan, 523000, China
| | - Da Lei
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China
| | - Bangming Xu
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China
| |
Collapse
|
2
|
Yao H, Lian L, Zheng R, Chen C. Red blood cell distribution width/platelet ratio on admission as a predictor for in-hospital mortality in patients with acute myocardial infarction: a retrospective analysis from MIMIC-IV Database. BMC Anesthesiol 2023; 23:113. [PMID: 37016294 PMCID: PMC10071654 DOI: 10.1186/s12871-023-02071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator. It integrates the risk prediction of RDW and platelet, which is associated with adverse outcomes. However, the predictive power of RPR in mortality for patients with acute myocardial infarction (AMI) remains uncertain. Thus, we aimed to explore the association between RPR and 180-day in-hospital mortality in patients with AMI. METHODS Data on patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into two groups according to the optimal RPR cut-off value. The survival curve between high and low RPR groups was plotted via the Kaplan-Meier (KM) method. Univariate and multivariate Cox regression analyses were performed to determine the association between RPR on admission and 180-day in-hospital mortality. RESULTS A total of 1266 patients were enrolled, of which 83 (6.8%) died within 180 days during the hospitalization. Compared with the survivor group, the non-survivor group had higher RPR on admission (0.11 ± 0.07 vs. 0.08 ± 0.06, P < 0.001). The KM curve indicated that the survival probability of low RPR group was higher than that of high RPR group. Multivariate Cox regression analysis demonstrated that higher RPR on admission was an independent and effective predictor of 180-day mortality in patients with AMI (hazard ratio [HR]: 2.677, 95% confidence interval [CI]: 1.159-6.188, P = 0.021). CONCLUSION Higher RPR was associated with higher in-hospital 180-day mortality in patients with AMI.
Collapse
Affiliation(s)
- Hongxia Yao
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liyou Lian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rujie Zheng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Chen
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| |
Collapse
|
3
|
Güler Kazancı E, Üstündağ Y, Akdoğan M, Yıldırım F, Arıkan EY, Huysal K. Red Cell Distribution Width to Platelet Count Ratio Reference Intervals in Premature Infants Beyond the First Week of Life. Fetal Pediatr Pathol 2023:1-8. [PMID: 36790354 DOI: 10.1080/15513815.2023.2178268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objective: Red cell distribution width (RDW) is a parameter of complete blood count (CBC). The RDW to platelet count ratio (RPR) is a new index that has been shown to reflect the severity of inflammation. We aim to determine the reference interval (RI) of RPR for premature newborns. Study design: The medical records of preterm infants who were followed up between January 2016 and December 2018 were reviewed. CBC levels were measured in 144 infants at <72 hours of age. Results: CBCs of infants (gestational age from 28 to 35weeks) had a RI of 0.038-0.126 for the RPR. The RI for RPR in infants with a gestational age of 32-35weeks was 0.042-0.129; and the RI for infants at 28-31weeks was 0.022-0.121. Conclusion: Establishment of RI for RPR in premature infants will allow clinical correlation of RPR alterations in this population.
Collapse
Affiliation(s)
- Elif Güler Kazancı
- Department of Pediatric Hemato-Oncology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Yasemin Üstündağ
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Müberra Akdoğan
- Department of Ophtalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Fatih Yıldırım
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Elif Yalçın Arıkan
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Kağan Huysal
- Department of Clinical Biochemistry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| |
Collapse
|
4
|
Gao WB, Hu LJ, Ma XL, Shi MJ, Wang CY, Ma Y, Song XJ, Zhu JH, Wang TB. A predictive model for identifying secondary underlying diseases of hemophagocytic lymphohistiocytosis. Front Immunol 2023; 14:1143181. [PMID: 37187741 PMCID: PMC10175773 DOI: 10.3389/fimmu.2023.1143181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Background Secondary hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disease of immune hyperactivation that arises in the context of infectious, inflammatory, or neoplastic triggers. The aim of this study was to establish a predictive model for the timely differential diagnosis of the original disease resulting in HLH by validating clinical and laboratory findings to further improve the efficacy of therapeutics for HLH. Methods We retrospectively enrolled 175 secondary HLH patients in this study, including 92 patients with hematologic disease and 83 patients with rheumatic disease. The medical records of all identified patients were retrospectively reviewed and used to generate the predictive model. We also developed an early risk score using multivariate analysis weighted points proportional to the β regression coefficient values and calculated its sensitivity and specificity for the diagnosis of the original disease resulting in HLH. Results The multivariate logistic analysis revealed that lower levels of hemoglobin and platelets (PLT), lower levels of ferritin, splenomegaly and Epstein-Barr virus (EBV) positivity were associated with hematologic disease, but young age and female sex were associated with rheumatic disease. The risk factors for HLH secondary to rheumatic diseases were female sex [OR 4.434 (95% CI, 1.889-10.407), P =0.001], younger age [OR 6.773 (95% CI, 2.706-16.952), P<0.001], higher PLT level [OR 6.674 (95% CI, 2.838-15.694), P<0.001], higher ferritin level [OR 5.269 (95% CI, 1.995-13.920), P =0.001], and EBV negativity [OR 27.656 (95% CI, 4.499-169.996), P<0.001]. The risk score included assessments of female sex, age, PLT count, ferritin level and EBV negativity, which can be used to predict HLH secondary to rheumatic diseases with an AUC of 0.844 (95% CI, 0.836~0.932). Conclusion The established predictive model was designed to help clinicians diagnose the original disease resulting in secondary HLH during routine practice, which might be improve prognosis by enabling the timely treatment of the underlying disease.
Collapse
Affiliation(s)
- Wei-bo Gao
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Li-juan Hu
- Peking University People’s Hospital, Peking University Institute of Haematology, Beijing, China
- National Clinical Research Center for Haematologic Disease, Beijing, China
- *Correspondence: Li-juan Hu, ; Ji-hong Zhu, ; Tian-bing Wang,
| | - Xiao-lu Ma
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Mao-jing Shi
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Chun-yu Wang
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Yong Ma
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Xiao-jing Song
- Department of Emergency, Peking University People’s Hospital, Beijing, China
| | - Ji-hong Zhu
- Department of Emergency, Peking University People’s Hospital, Beijing, China
- *Correspondence: Li-juan Hu, ; Ji-hong Zhu, ; Tian-bing Wang,
| | - Tian-bing Wang
- Trauma Center, Peking University People’s Hospital, Beijing, China
- *Correspondence: Li-juan Hu, ; Ji-hong Zhu, ; Tian-bing Wang,
| |
Collapse
|
5
|
Yang Y, Li YF, Hu K, Zhang SJ, Cui JF, Huang XT, He SM, Wang DD, Chen X. The Dosage Recommendation of Cyclosporin in Children with Hemophagocytic Lymphohistiocytosis based on Population Pharmacokinetic Model. Curr Pharm Des 2023; 29:2996-3004. [PMID: 38062660 DOI: 10.2174/0113816128286290231124055116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Cyclosporin is one of the therapeutic regimens for hemophagocytic lymphohistiocytosis (HLH); however, the optimal dosage of cyclosporine in children with HLH is unknown. It has been found that piperacillin-tazobactam affects the cyclosporine pharmacokinetic process in pediatric HLH patients. Thus, the purpose of the present study was to recommend cyclosporin dosage for pediatric HLH with and without piperacillin- tazobactam. METHODS A previously established cyclosporine population pharmacokinetic model for pediatric HLH patients has been used in this study to recommend optimal dosage based on Monte Carlo simulation. The pediatric HLH patients have been included in eight weight groups (5, 10, 20, 30, 40, 50, 60, 70 kg) for sixteen dosages (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 mg/kg), split into one dose or two doses. RESULTS The optimal cyclosporin dosages for children having HLH without piperacillin-tazobactam have been found to be 15, 13, 12, 11, 10, and 9 mg/kg, split into two doses for weights of 5-7, 7-10, 10-20, 20-28, 28-45, and 45-70 kg, respectively. For children with HLH, optimal cyclosporin dosages with piperacillin-tazobactam have been found to be 8 and 7 mg/kg, split into two doses for weights of 5-20 and 20-70 kg, respectively. CONCLUSION It is the first time that the cyclosporin dosage regimens for HLH in children have been developed based on Monte Carlo simulation, and the initial dosage optimizations of cyclosporine in pediatric HLH patients have been recommended.
Collapse
Grants
- CJ20229030,CJ20229030 Changzhou Science and Technology Bureau
- Jiangsu Provincial Commission of Health and Family Planning
- RC20552111,RC20552222,KC23114,XYRHCX2022005,XYRHCX2021011,RC20552111,RC20552222,XYRHCX2022005,KC23114,XYRHCX2021011 Xuzhou Medical University
Collapse
Affiliation(s)
- Yang Yang
- Department of Pharmacy, The Affiliated Changzhou Children's Hospital of Nantong University, Changzhou, Jiangsu 213003, China
| | - Ya-Feng Li
- Department of Pharmacy, Feng Xian People's Hospital, Xuzhou, Jiangsu 221700, China
| | - Ke Hu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Shi-Jia Zhang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Jia-Fang Cui
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xue-Ting Huang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Su-Mei He
- Department of Pharmacy, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jiangsu 215153, China
| | - Dong-Dong Wang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xiao Chen
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| |
Collapse
|