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

Abstract

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.