The Incidence, Clinical Outcomes, and Risk Factors of Thrombocytopenia in Intra-Abdominal Infection Patients: A Retrospective Cohort Study.

Qin Wu,Yuan Li,Guosheng Gu,Guanwei Li,Yunzhao Zhao,Gefei Wang,Jianan Ren,Jieshou Li,Jun Chen,Xiuwen Wu,Patrick Cy Woo

doi:10.1371/journal.pone.0147482

Abstract

BackgroundStudies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies.MethodsWe retrospectively studied 267 consecutively enrolled patients with intra-abdominal infections. Occurrence of thrombocytopenia was scanned for all patients. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with occurrence of hospital-acquired thrombocytopenia were included in a multivariable logistic regression analysis to determine thrombocytopenia predictors.ResultsMedian APACHE II score and SOFA score of the whole cohort was 12 and 3 respectively. The overall ICU mortality was 7.87% and the 28-day mortality was 8.98%. The incidence of thrombocytopenia among intra-abdominal infection patients was 21.73%. Regardless of preexisting or hospital-acquired one, thrombocytopenia is associated with an increased ICU mortality and 28-day mortality as well as length of ICU or hospital stay. A higher SOFA and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors.ConclusionsThis is the first study to identify a high incidence of thrombocytopenia in patients with intra-abdominal infections. Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia. More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients.

Highlights

Intra-abdominal infections (IAIs), defined as infections occurring within an abdominal organ or in the abdominal cavity, are a frequent and dangerous entity in the treatment of critically illness patients.[1]
A higher Sequential Organ Failure Assessment (SOFA) and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors. This is the first study to identify a high incidence of thrombocytopenia in patients with intraabdominal infections
Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia

Summary

Introduction

Intra-abdominal infections (IAIs), defined as infections occurring within an abdominal organ or in the abdominal cavity, are a frequent and dangerous entity in the treatment of critically illness patients.[1]. The epidemiology of thrombocytopenia has been investigated by several studies as well as the impact of thrombocytopenia on outcomes among critically illness patients[8]. [5, 10] To date, there remain no studies investigating thrombocytopenia incidence, clinical outcome and risk factors in IAI patients. This absence of data limits advances in the prevention of thrombocytopenia among these IAIs patients. Identification of the incidence, the impact on the outcome and risk factors of thrombocytopenia in IAI patients remains paramount. Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies

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Conclusion