The Mean Platelet Volume Combined with Procalcitonin as an Early Accessible Marker Helps to Predict the Severity of Necrotizing Enterocolitis in Preterm Infants

PURPOSE: This study aims to evaluate the value of the mean platelet volume (MPV) combined with procalcitonin (PCT) in predicting the severity of necrotizing enterocolitis (NEC) in preterm infants. METHODS: This was a retrospective cohort study conducted in a neonatal intensive care unit from January 2014 to July 2020. Premature neonates with NEC were enrolled. In this study, mild-moderate NEC was defined as Bell’s stage I and II, and severe NEC was defined as Bell’s stage III. The demographic data, blood cell count analysis, C-reactive protein and PCT were compared between the severe and mild-moderate groups. RESULTS: A total of 18 premature infants with NEC in the severe group and 57 infants in the mild-moderate group were enrolled. The MPV and PCT were all significantly higher in the severe group than in the mild-moderate group (P < 0.01), and white blood cells were lower in the severe group (P < 0.05). The results of logistic regression suggested that the MPV (OR = 6.194, P = 0.000) and PCT (OR = 1.093, P = 0.006) were independent predictive factors for the severity of NEC. A receiver operating characteristic analysis showed that the areas under the curve (AUCs) were 0.829 for MPV alone, 0.706 for PCT alone, and 0.895 for MPV combined with PCT. CONCLUSION: The combination of MPV with PCT had the highest overall AUC of the investigated parameters, and their combination can be considered an early marker for predicting the severity of NEC in preterm infants.