Trends of Platelet Indices in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Longitudinal Follow-Up Study.

Introduction Platelet indices, including platelet distribution width (PDW), mean platelet volume (MPV), and platelet count, are readily available markers of platelet activation and systemic inflammation. This study evaluated their association with disease severity and clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A prospective longitudinal follow-up study was conducted among 77 patients admitted with AECOPD at Kilpauk Medical College & Hospital, Chennai. PDW, MPV, and platelet count were assessed at admission and at two and four weeks. Patients were monitored for mechanical ventilation during hospitalization and subsequent hospital admissions. Associations were assessed using the chi-square test and independent t-test, with p<0.05 considered statistically significant. Results Of 77 participants, 63 (81.8%) were male subjects and 45 (58.4%) were aged 41-60 years. At admission, low PDW (<12%), MPV (<9 fL) and platelet count (<300,000/µL) were observed in 54 (70.1%), 59 (76.6%), and 56 (72.7%) participants, respectively. Nineteen subjects (24.7%) required mechanical ventilation and 21 (27.3%) had hospital admissions during follow-up. Higher PDW, MPV, and platelet count at admission were significantly associated with mechanical ventilation and hospital admissions (p=0.0005 for each). Persistently elevated PDW showed a highly significant association with the need for mechanical ventilation (χ² = 27.393, p=0.0005). Of the patients who required mechanical ventilation, 73.7% had persistently elevated PDW compared to only 12.1% among those who did not require ventilation. Conclusion Elevated and persistently elevated platelet indices, particularly PDW, MPV, and platelet count, were associated with mechanical ventilation and hospital admissions in patients with AECOPD. These routinely available parameters may help identify patients at higher risk of adverse outcomes.