Li Sheng-Zhong, Liu Shao-Hua, Hao Meng, Yu Tian, Hu Song, Liu Li, Liu Zhe-Long
Department of Surgery, Wuhan Jinyintan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Surg. 2023 Jul 25;10:1192523. doi: 10.3389/fsurg.2023.1192523. eCollection 2023.
Thrombocytopenia and poor prognosis in severe conditions are associated. However, the clinical significance of thrombocytopenia in pyogenic liver abscess (PLA) has not been evaluated.
To evaluate the association between thrombocytopenia and the prognosis of patients with PLA.
A consecutive case series of 458 adult patients with PLA hospitalized at Tongji Hospital (Wuhan, China) between October 2011 and June 2021 was included in this cross-sectional analysis. Patient data were compared between the thrombocytopenia and non-thrombocytopenia groups. Multivariate logistic regression, receiver operating characteristic (ROC) curve and propensity score -matched analyses (PSM) were performed.
Of the 458 patients with PLA, 94 (20.5%) developed thrombocytopenia, 19 (4.1%) developed septic shock, 14 (3.1%) were admitted to the ICU, and 15 (3.3%) died during hospitalization. Thrombocytopenia was independently associated with shock (95%CI = 3.529-57.944, < 0.001), ICU admission (95%CI = 1.286-25.733, = 0.022), and mortality (95%CI = 1.947-34.223, = 0.004) in multivariate regression analysis. ROC analysis showed that thrombocytopenia may be an identified marker of shock [area under the ROC curve (AUC), 0.8119; cut-off, 92.50; < 0.0001], ICU admission (AUC, 0.7484; cut-off, 82.50; < 0.0015), and mortality (AUC, 0.7827; cut-off, 122.50; < 0.002). These findings remained consistent across 86 pairs of patients analyzed for PSM analyses.
Thrombocytopenia is an independent risk factor for poor prognosis in PLA and patients may be more prone to adverse outcomes.
血小板减少症与严重疾病的不良预后相关。然而，血小板减少症在化脓性肝脓肿（PLA）中的临床意义尚未得到评估。
评估血小板减少症与PLA患者预后之间的关联。
本横断面分析纳入了2011年10月至2021年6月期间在同济医院（中国武汉）住院的458例成年PLA患者的连续病例系列。对血小板减少组和非血小板减少组的患者数据进行比较。进行了多因素逻辑回归、受试者工作特征（ROC）曲线分析和倾向得分匹配分析（PSM）。
在458例PLA患者中，94例（20.5%）出现血小板减少症，19例（4.1%）发生感染性休克，14例（3.1%）入住重症监护病房（ICU），15例（3.3%）在住院期间死亡。在多因素回归分析中，血小板减少症与休克（95%置信区间=3.529 - 57.944，P < 0.001）、入住ICU（95%置信区间=1.286 - 25.733，P = 0.022）和死亡率（95%置信区间=1.947 - 34.223，P = 0.004）独立相关。ROC分析表明，血小板减少症可能是休克（ROC曲线下面积[AUC]，0.8119；截断值，92.50；P < 0.0001）、入住ICU（AUC，0.7484；截断值，82.50；P < 0.0015）和死亡率（AUC，0.7827；截断值，122.50；P < 0.002）的一个确定标志物。在进行PSM分析的86对患者中，这些结果保持一致。
血小板减少症是PLA患者预后不良的独立危险因素，患者可能更容易出现不良结局。
