Impact of Various Platelet Indices and their Ratios in Prediction of Mortality in Septicemic Patients in Pediatric Population: A Prospective Study

Background: Role of platelet indices and their ratios in prediction of mortality in pediatric patients with sepsis. Settings and Design: This is a prospective study that was conducted in the Department of Pathology on 186 pediatric patients, in a tertiary heath center in central India, from September 2022 to February 2024. Material and Methods: Patient’s sample was taken at the time of admission and analysed in pathology lab. Clinical as well as laboratory data were collected and patients were divided into two categories survivors and non –survivors. Statistical analysis used: Parametric and non-parametric data were analyzed using Mann–Whitney U test, Chi-square test, ROC analysis, and logistic regression. Results: Non-survivors had lower platelet counts and PCT, and higher MPV, PDW, MPV/PLT, MPV/PCT, PDW/PLT, and PDW/PCT ratios compared to survivors (p<0.05). MPV at the time of admission was an independent risk factor for death [odds ratio :1.418 (95% Cl: 1.059-1.243); p=0.001]. The MPV/PCT ratio had ‘good’ discriminative power for non-survivors with a cut-off value of 33.26 (AUC=0.700, Sensitivity=72%, Specificity=63.7%). Conclusion: Platelet indices and their ratios are simple, cost-effective markers for early identification of high-risk pediatric sepsis patients, aiding timely intervention and better resource utilization, especially in resource-limited settings.

Keywords: Sepsis; Platelet indices; ratios; Pediatric population.