Mean platelet volume and neonatal sepsis: a systematic review and meta-analysis of diagnostic accuracy.

AIM: To determine the diagnostic accuracy of Mean Platelet Volume in neonatal sepsis.

METHODS

We systematically searched MEDLINE, Clinicaltrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and WHO (International Clinical Trials Register Platform) databases from inception using a structured algorithm. All observational studies were deemed eligible. Meta-analysis was performed using the RevMan 5.3 software and heterogeneity was assessed through subgroup and meta-regression analysis. Studies included in the meta-analysis were assessed using the Newcastle-Ottawa scale while studies used for the calculation of the diagnostic accuracy were evaluated using the Quality Assessment of Diagnostic Accuracy tool.

RESULTS

MPV levels were found significantly higher than in healthy neonates (SMD: 1.62, 95% CI 0.97-2.27 and p < 10-5). Subgroup analysis based on hematological analyzer, EDTA usage and venipuncture to analysis time below 120 min also showcased significantly higher SMD's in neonates with sepsis than in healthy. Sensitivity and specificity of MPV in neonatal sepsis were found to be 0.675 (95% CI: 0.536-0.790) and 0.733 (95% CI: 0.589-0.840), respectively, at an optimal cutoff point of 9.28fL.

CONCLUSION

MPV appears to have a fair diagnostic accuracy in sepsis investigation. Given its ready availability it may constitute an attractive adjunct for clinicians, especially in low-resource environments.