Diagnostic Value of Platelet Indices in Pulmonary Thromboembolism: A Retrospective Analysis

Background Timely and accurate diagnosis of pulmonary thromboembolism (PTE) in the emergency department (ED) is critical, yet remains challenging due to non-specific clinical features. Platelet indices have recently emerged as potential biomarkers, but their diagnostic utility is uncertain. Methods In this retrospective single-center study, 1198 adult patients who underwent CT pulmonary angiography for suspected PTE in a tertiary ED were analyzed. Demographic characteristics and a comprehensive panel of hematological, biochemical, and coagulation parameters were compared between PTE (n = 126) and non-PTE (n = 1072) groups. Multivariate logistic regression and ROC curve analyses were performed to assess independent predictors and diagnostic performance. Results Platelet indices including platelet count, mean platelet volume, platelet distribution width, plateletcrit, and derived ratios showed no significant differences between groups. However, PTE patients were older, more likely female, and exhibited significantly lower red blood cell count, hemoglobin, hematocrit, and higher neutrophil count (all P < .05). Multivariate analysis identified lower RBC and higher neutrophil count as independent predictors, while female sex was associated with decreased PTE risk. The model's discriminative ability was modest (AUC = 0.651). Conclusion Platelet indices do not provide diagnostic value for PTE in the ED. Traditional demographic and hematological markers may aid risk stratification, but clinical integration remains essential. Prospective studies are needed to validate these findings and enhance diagnostic pathways.