Mean platelet volume as a novel predictor of systemic inflammatory response in cirrhotic patients with culture-negative neutrocytic ascites

Table 1 Demographic characteristics of the patients

Variable	Group An= 50	Group Bn= 51	P	95%CI
Age (yr)	57 ± 9.8	55 ± 10.8	0.30	-1.9 to 6.2
Gender (female), n (%)	35 (70)	27 (53)	0.08
Child-Pugh A/B/C	9/26/15	0/7/44	< 0.0001
Cause of cirrhosis:
Alcohol	18	27	0.34
NASH	9	4
CHC	13	9
Autoimmune	2	2
Cryptogenic	8	9

Group A (controls: cirrhotic patients without infection); Group B (cases: cirrhotic patients with ascites infection); NASH: Non-alcoholic steatohepatitis; CHC: Chronic hepatitis C. P < 0.01 was considered statistical significant.

Table 2 Comparison between groups regard to different clinical and cellular parameters as predictors of pro-inflammatory acute response in presence of ascites infection in cirrhotic patients

Variable	Group An= 50	Group Bn= 51	P	95%CI
Leukocytes (103/mcl)	4.9 ± 2.1	12.4 ± 7.2	< 0.0001	-9.6 to -5.4
PMN (103/mcl)	3.0 ± 1.6	10.7 ± 6.8	< 0.0001	-9.6 to -5.7
Platelets (103/mcl)	106.7 ± 56.0	110.0 ± 69.0	0.80	-28.1 to 21.6
MPV (fl)	7.7 ± 0.5	9.0 ± 0.8	< 0.0001	-1.5 to -0.9
Hemoglobin (g/dL)	11.6 ± 2.5	11.1 ± 2.2	0.33	-0.5 to 1.4
MCV(fl)	89.7 ± 13.3	98.5 ± 9.4	< 0.0001	-13.3 to -4.3
MCH (pg)	30.1 ± 4.3	33.0 ± 3.7	< 0.0001	-4.5 to -1.3
RDW (%)	17.7 ± 3.1	18.3 ± 4.6	0.47	-2.1 to 1.0
MAP (mmHg)	81.9 ± 10.3	74.7 ± 16.1	0.009	1.8 to 12.5
CF (beats/min)	73 ± 16	96 ± 18	< 0.0001	-30.0 to -16.0
RF (breaths/min)	20 ± 2	24 ± 14	0.04	-8.4 to -0.2
Temperature (°C)	36.4 ± 0.5	36.7 ± 0.8	0.12	-0.5 to 0.6
SIRS, n (%)	0 (0)	38 (74.5)	< 0.0001	NA

Group A (controls: cirrhotic patients without infection); Group B (cases: cirrhotic patients with ascites infection); CF: Cardiac frequency; MAP: Mean arterial pressure; MCH: Mean corpuscular hemoglobin; MCV: Mean corpuscular volume; MPV: Mean platelet volume; PMN: Polymorphonuclear cells; RDW: Red cell distribution width; RF: Respiratory frequency; SIRS: Systemic inflammatory response syndrome. P < 0.01 was considered statistical significant.

Table 3 Clinical and hematological predictors of acute pro-inflammatory response in cirrhotic patients with ascites infection

Variable	AUROC	95%CI	P
Leukocytes	0.89	0.82-0.95	< 0.0001
PMN	0.94	0.90-0.99	< 0.0001
MPV	0.90	0.84-0.96	< 0.0001
MCV	0.73	0.63-0.83	< 0.0001
MCH	0.72	0.61-0.82	< 0.0001
CF	0.86	0.78-0.94	< 0.0001

PMN: Polymorphonuclear cells; MPV: Mean platelet volume; MCV: Mean corpuscular volume; MCH: Mean corpuscular hemoglobin; CF: Cardiac frequency; AUROC: Area under the receiving operating characteristic.

Table 4 Different cutoff values for mean platelet volume as indicators of inflammatory response in cirrhotic patients with ascites infection

Cutoff value (fl)	Sensibility % (95%CI)	Specificity % (95%CI)	PPV % (95%CI)	NPV % (95%CI)	Accuracy
8.0	92 (84-100)	62 (48-76)	71 (60-83)	89 (77-100)	77 (69-86)
8.1	88 (78-98)	78 (66-90)	80 (69-92)	87 (76-98)	83 (75-91)
8.2	84 (73-95)	80 (68-92)	81 (70-93)	83 (72-95)	82 (74-90)
8.3	84 (73-95)	82 (70-94)	83 (72-94)	84 (72-95)	83 (75-91)
8.4	78 (66-91)	88 (78-98)	87 (76-98)	80 (69-91)	83 (75-98)
8.5	76 (64-89)	88 (78-98)	87 (76-98)	78 (67-90)	82 (74-90)

NPV: Negative predictive value; PPV: Positive predictive value.