Decreased Maximum Amplitude as a Potential Parameter to Predict the Likelihood of Mortality in Complicated Intra-Abdominal Infection Patients with Thrombocytopenia.

BACKGROUND

Thrombocytopenia is one of the common serious complications among complicated intra-abdominal infection (cIAI) patients. Maximum amplitude (MA), a thromboelastography parameter, represents fibrinogen levels, platelet count, and platelet function. Our study aimed to elucidate the association between decreased MA and mortality among cIAI patients with thrombocytopenia.

METHODS

cIAI patients with thrombocytopenia were enrolled-in. Clinical data and various laboratory values were collected. Uni-variable analysis and multi-variable logistic regression were used to evaluate the correlation between decreased MA and mortality. The area under the curve (AUC) was calculated to evaluate the predictive performance.

RESULTS

A total of 58 cIAI patients with thrombocytopenia were included. According to the uni-variable analysis, decreased MA was significantly associated with patient mortality (odds ratio [OR]: 15.41, 95% confidence interval [CI]: 4.03-58.91; p < 0.001). In the multi-variable analysis model 1, which was adjusted for age and gender, decreased MA remained significantly associated with increased patient mortality (OR: 10.96, 95% CI: 2.44-49.20; p = 0.002). After adjusting for age, gender, platelet count, acute physiology and chronic health evaluation II score, and sequential organ failure assessment score (model 2), decreased MA was also a risk factor for patient mortality (OR: 12.66, 95% CI: 1.81-88.78; p = 0.011). MA levels were significantly lower in non-survivors than in survivors (all p < 0.05). The AUC of MA for predicting mortality was 0.72 (95% CI: 0.58-0.87; p = 0.0036).

CONCLUSION

Decreased MA may be a potential parameter to help predict the likelihood of mortality in cIAI patients with thrombocytopenia.