Diagnostic Performance of Platelet Volume Indices in Thrombocytopenia: A Single-Center Observational Study in Central India

Background: Platelet indices obtained from automated hematology analyzers may complement the evaluation of thrombocytopenia.Aim and objectives: The objective of this study is to assess mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) in relation to thrombocytopenia severity, clinical etiology, and underlying mechanism.Materials and methods: This observational cross-sectional study with prospective data collection was conducted over 18 months in the Department of Pathology at Amaltas Institute of Medical Sciences, Dewas, India.Convenience sampling yielded 324 patients with platelet counts below 150 × 10⁹/L.EDTAanticoagulated blood samples were analyzed within two hours using an Erba Elite 580 analyzer (Erba Diagnostics Mannheim GmbH, Mannheim, Germany), with peripheral smear assessment.Platelet indices were compared across severity and mechanism categories and evaluated using correlation and receiver operating characteristic analyses.Results: The mean age was 44.23 ± 12.92 years; 227 (70.1%) patients were male.Mild, moderate, and severe thrombocytopenia occurred in 211 (65.1%), 96 (29.6%), and 17 (5.2%)patients, respectively.PDW increased, and PCT decreased across severity categories (both p < 0.001), whereas MPV showed no significant difference (p = 0.94).Platelet count correlated positively with PCT (r = 0.91) and inversely with PDW (r = -0.31).Reported areas under the curve were 0.82 for PDW, 0.71 for PCT, and 0.58 for MPV.Conclusions: PDW showed the greatest reported discrimination between mechanism categories, while PCT closely reflected platelet count.The findings warrant further evaluation of platelet indices alongside clinical and peripheral smear assessment; their effect on diagnostic decisions and clinical outcomes was not assessed.Verification of mechanism classification and diagnostic analyses, followed by external validation, is required before clinical application.