Association of Immature Platelet Fraction and Trombopoietin Levels Based on the Grades of Sepsis Severity

Abstract

Sepsis is one of the major causes of morbidity and mortality around the world. Organ dysfunction in sepsis

can be identified using Sepsis-related Organ Failure Assessment. The dysfunction of the coagulation

cascade, the number of pro-inflammatory cytokines, and endothelial dysfunction promote the consumptive

thrombocytopenia in sepsis patients, which triggers a compensatory response in the body by increasing

thrombopoietin release. As a result, it increases platelet production which can be assessed by immature

platelet fraction (IPF). This study is a preliminary research to see the relationship between IPF values and

serum thrombopoietin (TPO) levels in terms of the clinical severity of patients with sepsis based on SOFA

scores. A cross-sectional design was performed in this study with 49 samples of patients with sepsis, collected

during June-July 2019, at Dr. Wahidin Sudirohusodo Hospital in Makassar. The study was conducted in

August 2019. IPF values were measured by the fluorescent flow cytometry method. Meanwhile, serum

thrombopoietin levels were calculated by the enzyme-linked immunosorbent assay (ELISA) method using

human Thrombopoietin ELISA (RayBioTech, Australia). The results showed that the IPF value increased

along with the SOFA score, followed by a decrease in platelet (p = 0.014). TPO levels presented an

upward along with SOFA scores with a decrease in platelet (p = 0.008). There was a significant correlation

between IPF values and TPO levels (r = 0.606, p <0.001) where the Immature Platelet Fraction score and

thrombopoietin levels increased with SOFA scores. In addition, there was also a positive correlation between

IPF values and TPO levels in sepsis patients.