The MPV/PLT ratio was significantly elevated in neonatal sepsis patients compared to controls (SMD 1.48), demonstrating its potential as a cost-effective diagnostic biomarker.
Meta-Analysis
Do platelet index ratios (MPV/PLT, PDW/PLT, PDW/PCT) accurately diagnose sepsis and predict mortality in neonatal and adult patients?
The MPV/PLT ratio shows promise as a cost-effective biomarker for sepsis diagnosis and prognosis, particularly in neonates.
Effect estimate: SMD 1.48 (95% CI 0.49-2.48)
p-value: p=0.004
BACKGROUND: Sepsis remains a major global health issue, especially in low- and middle-income countries (LMICs) with limited diagnostic resources. This meta-analysis evaluates platelet index ratios (mean platelet volume-to-platelet count, MPV/PLT; platelet distribution width-to-platelet count, PDW/PLT; and platelet distribution width-to-plateletcrit, PDW/PCT) as cost-effective biomarkers for sepsis diagnosis and prognosis in resource-constrained settings. METHODS: A systematic search was conducted for studies evaluating platelet parameter ratios in sepsis. Inclusion criteria comprised the following: (1) cohort/case-control designs; (2) non-duplicated datasets; (3) available quantitative data for meta-analysis. Exclusion criteria included reviews, abstracts, letters to the editor, and studies with incomplete data. Synthesis methods employed random-effects models to calculate standardized mean differences (SMD) and diagnostic metrics (sensitivity, specificity, etc.), with heterogeneity assessed via I-squared statistics. Publication bias was evaluated through funnel plots and Egger's test. RESULTS: Fourteen studies were included. The results revealed that MPV/PLT ratios were significantly higher in neonatal (SMD = 1.48, P = 0.004) and adult sepsis patients (SMD = 0.35, P < 0.001) than in controls. Survivors had significantly lower MPV/PLT ratios than non-survivors in both children/neonate (SMD = 0.67, P < 0.01) and adult group (SMD = 0.41, P < 0.01), with similar trends observed in longitudinal assessments. PDW/PLT was also lower in pediatric survivors (P = 0.009), while no significant differences were found for MPV/PCT in neonates or PDW/PLT in adults. For diagnosing sepsis, MPV/PLT had a sensitivity of 0.55 and specificity of 0.71 in adults, and 0.58 and 0.87 in neonates. For predicting mortality, neonatal sepsis showed higher sensitivity (89%) and specificity (73%) than adult sepsis (63%, 58%). In LMICs, MPV/PLT was elevated at admission in both age groups but was linked to survival only in neonates. CONCLUSION: The MPV/PLT ratio shows promise as a cost-effective biomarker for sepsis diagnosis and prognosis, particularly in neonatal patients, with important potential applications in LMICs. SYSTEMATIC REVIEW REGISTRATION: This study has been registered on the international platform of registered systematic review and meta-analysis protocols (INPLASY) (Registration Number: INPLASY202540096). https://doi.org/10.37766/inplasy2025.4.0096 .
Tong et al. (Wed,) conducted a meta-analysis in Sepsis. Mean platelet volume-to-platelet count (MPV/PLT) ratio vs. Non-sepsis controls was evaluated on MPV/PLT ratio in neonatal sepsis patients versus controls (SMD 1.48, 95% CI 0.49-2.48, p=0.004). The MPV/PLT ratio was significantly elevated in neonatal sepsis patients compared to controls (SMD 1.48), demonstrating its potential as a cost-effective diagnostic biomarker.