Emel Atas Berksoy, Murat Anıl


Objective: We aimed to investigate the relationship between trauma severity and platelet indices (PI) and white blood cell (WBC) count to identify traumatic brain injury (TBI) in children with minor head trauma (MHT). Materials and methods: This prospective study included children with acute isolated MHT who underwent head computed tomography (CT) based on Pediatric Emergency Care Research Network (PECARN) criteria. Mean platelet volume (MPV), platelet distribution width (PDW), MPV to platelet ratio (MPV/PL), MPV to white blood cell ratio (MPV/WBC), and MPV to Neutrophil ratio (MPV/Neu) were evaluated.

Results: 86 children with MHT and 245 controls were included the study. WBC, Neu count, MPV, MPV/WBC, MPV/Neu and MPV/PI ratios were statistically different among patients with abnormal CT, patients with normal CT and healthy controls (p<0.05). For predicting abbreviated injury score (AIS) > 1, the AUC values of WBC, neutrophil, MPV/WBC and MPV/Neu were 0.746, 0.739, 0.726 and 0.724, respectively.

Conclusion: In children with MHT who underwent CT, WBC, Neu counts, MPV/WBC and MPV/Neu ratios may be helpful for predicting the severity of trauma in pediatric emergency department.


children; complete blood count; head trauma; intracranial injury

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Faul M XL, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths. Atlanta, GA: US Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 2010.

Kuppermann N, Holmes JF, Dayan PS,Hoyle JD, Atabaki SM, Holubkov R et al . Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically important brain injuries after head trauma: a prospective cohort study. Lancet. 2009; 374(9696): 1160– 70.

De Long Jr. WG, Burn CT. Cytokines in patients with polytrauma. Clin Orthop Relat Res 2004; 422: 57– 5.

Sandhause LM, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am J Clin Pathol. 2002; 118(5): 787– 93.

Schnuriger B, Inaba K, Abdelsayed GA, Lustenberger T, Eberle BM, Barmparas G, et al. The impact of platelets on the progression of traumatic intracranial hemorrhage. J Trauma. 2010; 68(4): 881-5.

Nekludov M, Bellander BM, Blombäck M, Wallen HN.Platelet dysfunction in patients with severe traumatic brain injury. J Neurotrauma. 2007; 24(11): 1699-706.

Van der Loo B, Martin JF. A role for changes in platelet production in the cause of acute coronary syndromes. Arterioscler Thromb Vasc Biol. 1999; 19(3): 672–9.

Aksoy S, Kilickap S, Hayran M, Harputluoglu H, Koca E, Dede DS, et al. Platelet size has diagnostic predictive value for bone marrow metastasis in patients with solid tumors. Int J Lab Hematol. 2008; 30: 214–9.

Lippi G, Mattiuzzi C, Comelli I, Cervellin G. Mean platelet volume in patients with ischemic heart disease: Meta-analysis of diagnostic studies. Blood Coagul Fibrinolysis 2013; 24(2): 216–9.

Cay N, Ipek A, Gumus M, Birkan Z, Ozmen E. Platelet activity indices in patients with deep vein thrombosis. Clin Appl Thromb Hemost. 2012; 18(2): 206–10.

Acar E, Demir A, Alatas ÖD,Beydilli H, Yıldırım B, Kırlı U et al. Evaluation of hematological markers in minor head trauma in the emergency room. Eur J Trauma Emerg Surg. 2016; 42(5): 611- 6.

Yolcu S, Beceren GN, Tomruk Ö, Doguç DK, Balbaloglu O. Can mean platelet volume levels of trauma patients predict severity of trauma? Platelets. 2014; 25(4): 279–84.

Lippi G, Carbucicchio A, Benatti M, Cervellin G. The mean platelet volume is decreased in patients with mild head trauma and brain injury. Blood Coagul Fibrinolysis. 2013; 24(7): 780–3.

Rovlias A, Kotsou S. The Blood Leucocyte count and its prognostic significance in severe head injury. Surg Neurol 2001; 55(4): 190–6.

Gürkanlar D, Lakadamyalı H, Ergun T, Yilmaz C, Yücel E, Altinörs N. Predictive value of Leukocytosis in Head Trauma. Turk Neurosurg. 2009; 19(3):211-5.

Keskil S, Baykaner MK, Ceviker N, Ceviker N, Aykol Ş. Head trauma and leucocytosis. Acta Neurochir (Wien). 1994; 131(3-4): 211–4.

Pentelenyi T. Significance of endocrine studies in the general assessment and prediction of fatal outcome in head injury. Acta Neurochir Suppl (Wien). 1992; 55: 21–4.

Rosner MJ, Newsome HH, Becker DP. Mechanical brain injury: The sympathoadrenal response. J Neurosurg. 1984; 61(1): 76– 86.

Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis. 2006; 22(3): 161–4.

Cooke J, Murphy T, McFadden E, O’Reilly M, Cahill MR. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease? Hematology. 2009; 14(2): 111–4.

Robbins G, Barnard DL. Mean platelet volume changes in infection. J Clin Pathol. 1983; 36(11): 1320.

Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008; 75(3): 291–4.

Makay B, Türkyilmaz Z, Unsal E. Mean platelet volume in children with familial Mediterranean fever. Clin Rheumatol. 2009; 28(8): 975–8.

Turfan M, Erdogan E, Ertas G, Duran M, Murat SN, Celik E, et al. Usefulness of mean platelet volume for predicting stroke risk in atrial fibrillation patients. Blood Coagul Fibrinolysis. 2013; 24(1): 55–8.

Thompson CB. From precursor to product: How do megakaryocytes produce platelets? Prog Clin Biol Res. 1986; 215: 361–71.

Lippi G, Salvagno GL, Targher G, Guidi GC. Relationship between mean platelet volume and biochemical components of the metabolic syndrome. Clin Drug Investig. 2007; 27(10): 731–2.

DOI: http://dx.doi.org/10.24125/sanamed.v14i1.314


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