Mean Platelet Volume/Platelet Count Ratio is Associated with Poor Clinical Outcome After Aneurysmal Subarachnoid Hemorrhage

J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105208. doi: 10.1016/j.jstrokecerebrovasdis.2020.105208. Epub 2020 Aug 4.


Background: Aneurysmal subarachnoid hemorrhage (aSAH) is both a hypercoagulable and inflammation state in which many biomarkers have been studied. Activated platelets have been identified to be of clinical importance in thrombosis and neuroinflammation after aSAH. The aim of this study was to investigate the relationship between mean platelet volume (MPV) to platelet count (PC) ratio, a surrogate parameter for activated platelets, and the functional outcome in aSAH patients.

Methods: A retrospective analysis was performed of patients with aSAH admitted to the stroke center of our institution between November 2018 and November 2019. The mean MPV/PC ratio during the first three days after aSAH onset was calculated. Poor outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months. Receive operating characteristic (ROC) curve analysis was performed to determine the optimal value of MPV/PC ratio for the prediction of poor outcome in patients with aSAH.

Results: A total of 100 patients were included, 13 (13.0%) died and 35 (35.0%) had a poor outcome. Mean MPV/PC ratio (P < 0.001) when measured over the study period, was significantly higher among patients with poor outcome. In multivariable analysis, increased mean MPV/PC ratio was associated with poor functional outcome at 3 months (odds ratio (OR) = 1.94; 95% confidence interval (CI): 1.19-3.17; P = 0.008). The optimal cutoff of MPV/PC ratio for predicting poor outcome at 3 months was 6.77 (sensitivity 74.3%, specificity 61.5%).

Conclusion: An increased MPV/PC ratio is associated with poor functional outcome in aSAH patients. MPV/PC ratio may be a useful predictor of outcome after aSAH.

Keywords: Activated platelets; Biomarker; Outcomes; Subarachnoid hemorrhage.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Platelets*
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Mean Platelet Volume*
  • Middle Aged
  • Platelet Activation*
  • Platelet Count*
  • Predictive Value of Tests
  • Recovery of Function
  • Reproducibility of Results
  • Retrospective Studies
  • Subarachnoid Hemorrhage / blood
  • Subarachnoid Hemorrhage / diagnosis*
  • Subarachnoid Hemorrhage / physiopathology
  • Subarachnoid Hemorrhage / therapy
  • Treatment Outcome