Publication:

Comparative study of platelet indices in cirrhosis, cirrhosis with sepsis and normal population

Background Platelet indices are the first hematologic indices to be affected in cirrhosis. Cirrhosis patients are particularly susceptible to bacterial infections. The incidence of sepsis in cirrhosis is estimated to be at least 30-50% of hospital admissions. Sepsis also causes alterations in platelet indices. We studied and compared the platelet indices namely platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and platecrit in cirrhosis, cirrhosis with sepsis and normal control population.

Methods This observational study included forty cirrhosis, forty three cirrhosis with sepsis and sixty one controls. Platelet indices were reviewed and compared between the groups and correlation of platelet indices with CTP score, MELD, platelet count and spleen size was also evaluated.

Results Platelet indices were significantly altered in cirrhosis compared to normal population. MPV and PDW were significantly higher in cirrhosis compared to control population. Platelet count and platecrit were significantly lower in cirrhosis compared to control population. CTP score and MELD showed significant positive correlation with MPV and platelet count showed significant negative correlation with PD. Sepsis in cirrhosis was associated with significant decrease in platelet count and platecrit but caused significant increase in PDW compared to cirrhosis without sepsis. Cirrhosis with sepsis group had four patients with variceal bleeding with significantly higher mean PDW(19%) and significantly lower mean platecrit (0.04) compared to nonbleeding group (p value <0.05).

Conclusions Platelet indices are useful parameters in cirrhosis. Other than platelet count, PDW and platecrit are useful indices to be monitored in cirrhosis with sepsis.