Association of mean platelet volume-to-platelet count ratio for 24-hour mortality in patients with severe trauma

Mean platelet volume (MPV) may be associated with trauma patients' outcomes. However, the relationship between the MPV-to-platelet count ratio (MPR) and the result of severe trauma has not been reported. This study aimed to analyze and compare the prognostic performances of MPV and MPR in severe trauma. This retrospective observational study included adult patients admitted for severe trauma between January 2022 and December 2022. Multivariable logistic regression analysis assessed the association of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and MPR for 24-hour mortality. Receiver operating characteristic analysis was used to examine the prognostic performance of MPV, NLR, PLR, and MPR for 24-hour mortality. Among the 325 patients included in the study, 24-hour mortality was 10.8% (n = 35). At admission, non-survivors had lower PLR (26.1 vs 32.5) and higher MPR (0.07 vs 0.04) than survivors. The areas under the receiver operating characteristic curves for MPV, NLR, PLR, and MPR were 0.571 (95% confidence interval [CI], 0.515-0.625), 0.539 (95% CI, 0.484-0.595), 0.618 (95% CI, 0.563-0.671), and 0.715 (95% CI, 0.662-0.763), respectively. The MPR cutoff value for predicting 24-hour mortality was 0.06. Results from multivariable regression analysis revealed that an MPR > 0.06 was independently associated with 24-hour mortality (odds ratio, 3.400; 95% CI, 1.397-8.273), while NLR and PLR were not. MPR is associated with 24-hour mortality in severe trauma and has the potential capacity as a prognostic predictor. MPR could help quickly identify patients with severe trauma and implement appropriate interventions.