Zhongguo quanke yixue (Jun 2023)
Risk Factors of Thrombocytopenia Caused by Pyogenic Liver Abscess
Abstract
Background Pyogenic liver abscess (PLA) is a common visceral infectious disease, its associated thrombocytopenia has been rarely studied clinically. Objective To discuss the epidemiological and clinical characteristics as well as risk factors of thrombocytopenia secondary to PLA. Methods All 161 patients hospitalized for PLA in Peking University People's Hospital from January 2011 to December 2020 were recruited. Patient data were collected, including general demographics〔age, gender, body mass index (BMI) , symptoms (fever, abdominal pain, nausea, vomiting) , and past medical history information (hypertension, diabetes, coronary heart disease, hepatobiliary disease, and cancer) , auxiliary examination results, including white blood cell count, absolute neutrophil count, absolute lymphocyte count (ALC) , absolute monocyte count, hemoglobin, C-reactive protein (CRP) , procalcitonin (PCT) , alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBiL) , blood urea nitrogen (BUN) , serum creatinine (Scr) , albumin (ALB) , prothrombin time (PT) , activated partial thromboplastin time, fibrinogen, D-Dimer, platelet count (PLT) 〕, imaging examination results (abdominal CT or ultrasonographic findings of liver abscesses) , pathogenic examination results (blood culture, prevalence of cultured Klebsiella pneumoniae) and complications and prognosis. The above-mentioned data were compared between group with decreased PLT (n=21) and group without decreased PLT (n=140) divided by the prevalence of PLT less than 100×109/L. The risk factors of thrombocytopenia were analyzed by multivariate Logistic regression analysis. Results The mean BMI in PLT reduction group was statistically significant higher than that in non-PLT reduction group (P<0.05) . PLT reduction group had much lower mean levels of ALC and ALB, PT, and much higher mean levels of CRP, PCT, ALT, AST, TBiL, BUN, Scr and D-Dimer than non-PLT reduction group (P<0.05) . Furthermore, PLT reduction group had significantly higher prevalence of concomitant pneumonia, brain abscess and ICU admission (P<0.05) . ALB〔OR=0.255, 95%CI (0.074, 0.877) 〕and PT〔OR=0.282, 95%CI (0.085, 0.941) 〕were influencing factors for thrombocytopenia in PLA (P<0.05) . Conclusion ALB and PT are the influencing factors of thrombocytopenia in PLA patients. PLT levels should be closely monitored in PLA patients, especially those with reduced ALB and decreased PT.
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