Thrombocytopenia as an important determinant of poor prognosis in patients with pyogenic liver abscess: a retrospective case series

Sheng-Zhong Li; Shao-Hua Liu; Meng Hao; Tian Yu; Song Hu; Li Liu; Zhe-Long Liu

doi:10.3389/fsurg.2023.1192523

Thrombocytopenia as an important determinant of poor prognosis in patients with pyogenic liver abscess: a retrospective case series

Front Surg. 2023 Jul 25:10:1192523. doi: 10.3389/fsurg.2023.1192523. eCollection 2023.

Authors

Sheng-Zhong Li^#¹, Shao-Hua Liu^#^{2

3}, Meng Hao⁴, Tian Yu^{2

3}, Song Hu⁵, Li Liu^{2

3}, Zhe-Long Liu^{2

3}

Affiliations

¹ Department of Surgery, Wuhan Jinyintan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China.
⁴ Department of Gastroenterology, Zigui County People's Hospital, Yichang, China.
⁵ Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

^# Contributed equally.

Abstract

Background: Thrombocytopenia and poor prognosis in severe conditions are associated. However, the clinical significance of thrombocytopenia in pyogenic liver abscess (PLA) has not been evaluated.

Objective: To evaluate the association between thrombocytopenia and the prognosis of patients with PLA.

Methods: 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.

Results: 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, P < 0.001), ICU admission (95%CI = 1.286-25.733, P = 0.022), and mortality (95%CI = 1.947-34.223, P = 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; P < 0.0001], ICU admission (AUC, 0.7484; cut-off, 82.50; P < 0.0015), and mortality (AUC, 0.7827; cut-off, 122.50; P < 0.002). These findings remained consistent across 86 pairs of patients analyzed for PSM analyses.

Conclusions: Thrombocytopenia is an independent risk factor for poor prognosis in PLA and patients may be more prone to adverse outcomes.

Keywords: cross-sectional analysis; platelet count; prognosis; pyogenic liver abscess; thrombocytopenia.

Grants and funding

This work was supported by the Sen-Mei China Diabetes Research Fund (Z-2017-26-1902), Teaching Research Project of Huazhong University of Science and Technology (2022141 to LL), and Teaching Research Fund of the Second Clinical College of Huazhong University of Science and Technology (2021058 to LL).