The prognostic effect of lymphocyte, monocyte, and platelet counts, mean platelet volume, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio on different stages of pressure ulcers

Hematological parameters and pressure ulcer stage



pressure ulcer, pressure ulcer stage, hematological parameters, intensive care unit


Background/Aim: Pressure ulcers (PU) pose a significant problem for patients in intensive care. Various factors contribute to the development of pressure sores. The primary focus of treatment is to implement measures that prevent factors such as nutrition and positioning, which can lead to PUs. Therefore, it is crucial to identify parameters that can serve as warning signals for the formation and progression of PU. This study investigates the potential use of hematological parameters as warning signals.

Methods: Demographic data, co-morbidities, PU stages, and laboratory parameters of 158 patients hospitalized in the intensive care unit who developed pressure ulcers during their hospital stay were recorded and analyzed.

Results: Among the 158 cases included in the study, PUs were more prevalent in patients of advanced age, those with pneumonia, chronic obstructive pulmonary disease (COPD), coronary diseases, and neurodegenerative diseases. Mean platelet volume (MPV) was significantly higher in PU stages 2 and 3 compared to stage 1. However, age, lymphocyte count, monocyte count, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) did not exhibit significant differences among the stages of PU (P<0.05).

Conclusion: Advanced age, pneumonia, COPD, coronary diseases, and neurodegenerative diseases are identified as risk factors for PU. Although MPV was initially considered a potential, stimulating parameter, the evidence was insufficient. Further research is required to explore this issue. The impact of parameters other than MPV did not show any excitatory signal in this study.


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Firat Kiliç H, Sucudag G. The scales frequently used in patients with the Assessment of Pressure Sores. G.O.P. Taksim E.A.H. JAREN. 2017;3(1):49-54. DOI:

Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018;18(1):305. DOI:

Adıyeke E, Adıyeke L. Neutrophil to lymphocyte ratio and mean platelet volume may predict the development of the pressure ulcers. J Surg Med. 2020;4(7):578-81. DOI:

Shi C, Dumville JC, Cullum N. Support surfaces for pressure ulcer prevention: A network meta-analysis. Plos One. 2018;13(2):e0192707. DOI:

Dincer M, Doger C, Tas SS, Karakaya D. An analysis of patients in palliative care with pressure injuries. Niger J Clin Pract. 2018;21:484-91. DOI:

Manzano F, Perez-Perez AM, Martinez-Ruiz S, Garrido-Colmenero C, Roldan D, Jiménez-Quintana Mdel M, et al. Hospital-acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation. J Eval Clin Pract. 2014;20:362-8. DOI:

Labeau SO, Afonso E, Benbenishty J, Blackwood B, Boulanger C, Brett SJ, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study. Intensive Care Med. 2021;47(2):160-9. DOI:

Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. J Clin Nurs. 2010;19(3–4):414–21. DOI:

Cox J. Pressure Injury Risk Factors in Adult Critical Care Patients: A Review of the Literature. Ostomy Wound Manage. 2017;63(11):30–43.

Aloweni F, Ang SY, Fook-Chong S, Agus N, Yong P, Goh MM, et al. A prediction tool for hospital-acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score. Int Wound J. 2019;16(1):164-75. DOI:

Lopatina T, Bruno S, Tetta C, Kalinina N, Porta M, Camussi G. Platelet-derived growth factor regulates the secretion of extracellular vesicles by adipose mesenchymal stem cells and enhances their angiogenic potential. Cell Communication and Signaling. 2014;12(1):26–38. DOI:

Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019;17;2019:9213074. DOI:

Koca Kutlu A, Diramalı A, Temiz C, Onur E, Miskioğlu M. Effect of exercise on blood values and vital findings in bed-connected patients. Journal Of Ege University Faculty of Nursing. 2011;27(1):25-36.

Erben Durmusoglu S, Kiliç F, Unsal M, Aytekin O, Kimyon Comert G, Karalok A, et al. Preoperative neutrophil/lymphocyte, lymphocyte/monocyte and platelet/lymphocyte ratios serous ovarian cancer survival Balikesir Medical Journal. 2021;5(1):43-53. DOI:

Dede S. In Critical Patients Diagnosed Wıth Covid-19, Platelet Lymphocyte Rate, Monocyte Lymphocyte Rate And Some Others Effect Of Hematological Values On Prognosis. (Master thesis in medicine), Konya, Necmettin Erbakan University 2021.






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Delen LA, Öterkuş M. The prognostic effect of lymphocyte, monocyte, and platelet counts, mean platelet volume, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio on different stages of pressure ulcers: Hematological parameters and pressure ulcer stage. J Surg Med [Internet]. 2023 Aug. 23 [cited 2024 Jun. 23];7(8):481-5. Available from: