AUTHOR=Li Sheng-zhong , Liu Shao-hua , Hao Meng , Yu Tian , Hu Song , Liu Li , Liu Zhe-long 

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

JOURNAL=Frontiers in Surgery

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1192523

DOI=10.3389/fsurg.2023.1192523

ISSN=2296-875X

ABSTRACT=<sec><title>Background</title><p>Thrombocytopenia and poor prognosis in severe conditions are associated. However, the clinical significance of thrombocytopenia in pyogenic liver abscess (PLA) has not been evaluated.</p></sec><sec><title>Objective</title><p>To evaluate the association between thrombocytopenia and the prognosis of patients with PLA.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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, <italic>P</italic> &lt; 0.001), ICU admission (95%CI = 1.286–25.733, <italic>P</italic> = 0.022), and mortality (95%CI = 1.947–34.223, <italic>P</italic> = 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; <italic>P</italic> &lt; 0.0001], ICU admission (AUC, 0.7484; cut-off, 82.50; <italic>P</italic> &lt; 0.0015), and mortality (AUC, 0.7827; cut-off, 122.50; <italic>P</italic> &lt; 0.002). These findings remained consistent across 86 pairs of patients analyzed for PSM analyses.</p></sec><sec><title>Conclusions</title><p>Thrombocytopenia is an independent risk factor for poor prognosis in PLA and patients may be more prone to adverse outcomes.</p></sec>