Use of platelet count on admission for determining illness severity and predicting prognosis in acute cholangitis patients

Abstract

Background Thrombocytopenia often occurs in patients with acute cholangitis and is a risk factor for poor prognosis in acute cholangitis. The study was to investigate the relationship between platelet count and illness severity and their performances in predicting hospital mortality. Methods This was a single-center, retrospective, observational cohort study. We analyzed 498 patients with acute cholangitis who were admitted to our hospital between July 2013 and July 2021. The correlation between admission platelet count and severity and prognosis of patients was analyzed. Results 1) In this study, the incidence of acute cholangitis thrombocytopenia (platelet count < 100×109/L) and severe thrombocytopenia (platelet count < 50×109/L) were 31.12% and 7.43%, respectively. 2) Platelet count of the Thrombocytopenia group was 64(42, 79) × 109/L. Compared with the NO-Thrombocytopenia group, the Thrombocytopenia group had more Grade III patients, higher complication rates (respiratory failure, circulatory failure, bacteremia), and higher APACHE II score and SOFA score (P < 0.05). 3) The 60-day mortality rate was significantly higher in the Thrombocytopenia group than that in the NO-Thrombocytopenia group (12.90% vs. 2.33%, P < 0.001). Binary logistic regression analysis demonstrated that platelet count at hospital admission was a risk factor for death. 4) ROC curve analysis showed that platelet count cut-off value for predicting the death of patients with acute cholangitis was 84×109/L, with sensitivity of 0.764, specificity of 0.714, and an AUC of 0.760. Conclusions Platelet count is a readily available, prognostic marker that can identify acute cholangitis patients with poorer outcome.