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Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Septicemia | Research

Prognostic value of platelet count-related ratios on admission in patients with pyogenic liver abscess

Authors: Shixiao Li, Sufei Yu, Jiajia Qin, Minfei Peng, Jiao Qian, Peng Zhou

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Objective

The purpose of the current study was to evaluate the association between C-reactive protein-to-platelet ratio (CPR), neutrophil-to-lymphocyte*platelet ratio (NLPR) and fibrinogen-to-platelet ratio (FPR) and the prognoses of pyogenic liver abscess (PLA) patients.

Methods

A cohort of 372 patients with confirmed PLA were enrolled in this retrospective study between 2015 and 2021. Laboratory data were collected on admission within 24 h. The demographic characteristics and clinical features were recorded. Risk factors for outcomes of PLA patients were determined via multivariate logistic regression analyses, and optimal cut-off values were estimated by using the receiver operating characteristic (ROC) curve analysis.

Results

Out of 372 patients, 57.8% were men, 80 (21.5%) developed sepsis, and 33 (8.9%) developed septic shock. The levels of CPR, NLPR and FPR were significantly increased in the development of sepsis, and prolonged hospital stays in PLA patients. The multivariate logistic regression analysis indicated that the CPR (OR: 2.262, 95% CI: 1.586–3.226, p < 0.001), NLPR (OR: 1.118, 95% CI: 1.070–1.167, p < 0.001) and FPR (OR: 1.197, 95% CI: 1.079–1.329, p = 0.001) were independent risks of PLA patients with sepsis, and NLPR (OR: 1.019, 95% CI: 1.004–1.046, p = 0.019) was shown to be an independent predictor of prolonged hospital stays. The ROC curve results showed that the three biomarkers had different predictive values, and CPR proved to work best, with a ROC value of 0.851 (95% CI: 0.807–0.896, p < 0.001) for sepsis.

Conclusion

Higher levels of CPR, NLPR and FPR were associated with a higher risk of poor outcomes. Moreover, a high CPR level performed best when predicting the clinical outcome in PLA patients.
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Literature
1.
go back to reference Chen YC, Lin CH, Chang SN, Shi ZY. Epidemiology and clinical outcome of pyogenic liver abscess: an analysis from the National Health Insurance Research Database of Taiwan, 2000–2011. J Microbiol Immunol Infect. 2016;49(5):646–53.CrossRef Chen YC, Lin CH, Chang SN, Shi ZY. Epidemiology and clinical outcome of pyogenic liver abscess: an analysis from the National Health Insurance Research Database of Taiwan, 2000–2011. J Microbiol Immunol Infect. 2016;49(5):646–53.CrossRef
2.
go back to reference Xu S, Shi BQ, Chao LM, Tan YS, Zhang XJ. Prognostic nomogram for the combination therapy of percutaneous catheter drainage and antibiotics in pyogenic liver abscess patients. Abdom Radiol (NY). 2020;45(2):393–402.CrossRef Xu S, Shi BQ, Chao LM, Tan YS, Zhang XJ. Prognostic nomogram for the combination therapy of percutaneous catheter drainage and antibiotics in pyogenic liver abscess patients. Abdom Radiol (NY). 2020;45(2):393–402.CrossRef
3.
go back to reference Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH, Huang CK, Liu YC. Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis. 2008;47(5):642–50.CrossRef Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH, Huang CK, Liu YC. Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis. 2008;47(5):642–50.CrossRef
4.
go back to reference Cho H, Lee ES, Lee YS, Kim YJ, Sohn CH, Ahn S, Seo DW, Lee JH, Kim WY, Lim KS. Predictors of septic shock in initially stable patients with pyogenic liver abscess. Scand J Gastroenterol. 2017;52(5):589–94.CrossRef Cho H, Lee ES, Lee YS, Kim YJ, Sohn CH, Ahn S, Seo DW, Lee JH, Kim WY, Lim KS. Predictors of septic shock in initially stable patients with pyogenic liver abscess. Scand J Gastroenterol. 2017;52(5):589–94.CrossRef
5.
go back to reference Meddings L, Myers RP, Hubbard J, Shaheen AA, Laupland KB, Dixon E, Coffin C, Kaplan GG. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105(1):117–24.CrossRef Meddings L, Myers RP, Hubbard J, Shaheen AA, Laupland KB, Dixon E, Coffin C, Kaplan GG. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105(1):117–24.CrossRef
6.
go back to reference Wang HR, Ren Y, Chang ZH, Liu Z. The increased recurrence rate of liver abscess caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis. 2020;39(7):1315–20.CrossRef Wang HR, Ren Y, Chang ZH, Liu Z. The increased recurrence rate of liver abscess caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis. 2020;39(7):1315–20.CrossRef
7.
go back to reference Lee JH, Jang YR, Ahn SJ, Choi SJ, Kim HS. A retrospective study of pyogenic liver abscess caused primarily by Klebsiella pneumoniae vs non-Klebsiella pneumoniae: CT and clinical differentiation. Abdom Radiol (NY). 2020;45(9):2669–79.CrossRef Lee JH, Jang YR, Ahn SJ, Choi SJ, Kim HS. A retrospective study of pyogenic liver abscess caused primarily by Klebsiella pneumoniae vs non-Klebsiella pneumoniae: CT and clinical differentiation. Abdom Radiol (NY). 2020;45(9):2669–79.CrossRef
8.
go back to reference Law ST, Li KK. Role of C-reactive protein in response-guided therapy of pyogenic liver abscess. Eur J Gastroenterol Hepatol. 2014;26(2):179–86.CrossRef Law ST, Li KK. Role of C-reactive protein in response-guided therapy of pyogenic liver abscess. Eur J Gastroenterol Hepatol. 2014;26(2):179–86.CrossRef
9.
go back to reference Lin L, Yang F, Wang Y, Su S, Su ZY, Jiang XH, Zheng YM, Deng Y, Lv HN, Zhao JW, Lin R, Wang BM, Sun C. Prognostic nomogram incorporating neutrophil-to-lymphocyte ratio for early mortality in decompensated liver cirrhosis. Int Immunopharmacol. 2018;56:58–64.CrossRef Lin L, Yang F, Wang Y, Su S, Su ZY, Jiang XH, Zheng YM, Deng Y, Lv HN, Zhao JW, Lin R, Wang BM, Sun C. Prognostic nomogram incorporating neutrophil-to-lymphocyte ratio for early mortality in decompensated liver cirrhosis. Int Immunopharmacol. 2018;56:58–64.CrossRef
10.
go back to reference Yuan DS, Jiang P, Zhu P, Jia SD, Zhang C, Liu Y, Liu R, Xu JJ, Tang XF, Zhao XY, Gao RL, Yang YJ, Xu B, Gao Z, Yuan JQ. Prognostic value of fibrinogen in patients with coronary artery disease and prediabetes or diabetes following percutaneous coronary intervention: 5-year findings from a large cohort study. Cardiovasc Diabetol. 2021;20(1):143.CrossRef Yuan DS, Jiang P, Zhu P, Jia SD, Zhang C, Liu Y, Liu R, Xu JJ, Tang XF, Zhao XY, Gao RL, Yang YJ, Xu B, Gao Z, Yuan JQ. Prognostic value of fibrinogen in patients with coronary artery disease and prediabetes or diabetes following percutaneous coronary intervention: 5-year findings from a large cohort study. Cardiovasc Diabetol. 2021;20(1):143.CrossRef
11.
go back to reference Li XJ, Li TW, Wang JJ, Feng YC, Ren C, Xu Z, Yang JM, Zhang Q, An CY. Clinical value of C-reactive protein/platelet ratio in neonatal sepsis: a cross-sectional study. J Inflamm Res. 2021;14:5123–9.CrossRef Li XJ, Li TW, Wang JJ, Feng YC, Ren C, Xu Z, Yang JM, Zhang Q, An CY. Clinical value of C-reactive protein/platelet ratio in neonatal sepsis: a cross-sectional study. J Inflamm Res. 2021;14:5123–9.CrossRef
12.
go back to reference Xu YC, Jin XY, Shao XN, Zheng F, Zhou H. Valuable prognostic indicators for severe burn sepsis with inhalation lesion: age, platelet count, and procalcitonin. Burns Trauma. 2018;6:29.CrossRef Xu YC, Jin XY, Shao XN, Zheng F, Zhou H. Valuable prognostic indicators for severe burn sepsis with inhalation lesion: age, platelet count, and procalcitonin. Burns Trauma. 2018;6:29.CrossRef
13.
go back to reference Sun LJ, Wei YX, Chen Y, Hu WM, Ji X, Xu HF, Du SD, Zhao HT, Lu X, Sang XT, Zhong SX, Yang HY, Mao YL. Comparison of the prognostic value of platelet-related indices in biliary tract cancer undergoing surgical resection. Cancer Res Treat. 2021;53(2):528–40.CrossRef Sun LJ, Wei YX, Chen Y, Hu WM, Ji X, Xu HF, Du SD, Zhao HT, Lu X, Sang XT, Zhong SX, Yang HY, Mao YL. Comparison of the prognostic value of platelet-related indices in biliary tract cancer undergoing surgical resection. Cancer Res Treat. 2021;53(2):528–40.CrossRef
14.
go back to reference Zhang XY, Svn Z, Liv MS, Liu MN, Zhang YH, Sun Q. Assessment of prognostic value of aspartate aminotransferase-to-platelet ratio index in patients with hepatocellular carcinoma: meta-analysis of 28 cohort studies. Front Med (Lausanne). 2021;8: 756210.CrossRef Zhang XY, Svn Z, Liv MS, Liu MN, Zhang YH, Sun Q. Assessment of prognostic value of aspartate aminotransferase-to-platelet ratio index in patients with hepatocellular carcinoma: meta-analysis of 28 cohort studies. Front Med (Lausanne). 2021;8: 756210.CrossRef
16.
go back to reference Huang C, Seah JJ, Tan CK, Kam JW, Tan J, Teo EK, Kwek A, Wong YJ, Tan M, Ang TL, Kumar R. Modified AST to platelet ratio index improves APRI and better predicts advanced fibrosis and liver cirrhosis in patients with non-alcoholic fatty liver disease. Clin Res Hepatol Gastroenterol. 2021;45(4): 101528.CrossRef Huang C, Seah JJ, Tan CK, Kam JW, Tan J, Teo EK, Kwek A, Wong YJ, Tan M, Ang TL, Kumar R. Modified AST to platelet ratio index improves APRI and better predicts advanced fibrosis and liver cirrhosis in patients with non-alcoholic fatty liver disease. Clin Res Hepatol Gastroenterol. 2021;45(4): 101528.CrossRef
17.
go back to reference Peris J, Bellot P, Roig P, Reus S. Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study. BMC Geriatr. 2017;17:161.CrossRef Peris J, Bellot P, Roig P, Reus S. Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study. BMC Geriatr. 2017;17:161.CrossRef
18.
go back to reference Foo NP, Chen KT, Lin HJ, Guo HR. Characteristics of pyogenic liver abscess patients with and without diabetes mellitus. Am J Gastroenterol. 2010;105(2):328–35.CrossRef Foo NP, Chen KT, Lin HJ, Guo HR. Characteristics of pyogenic liver abscess patients with and without diabetes mellitus. Am J Gastroenterol. 2010;105(2):328–35.CrossRef
19.
go back to reference Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard G, Chiche J, Coopersmith C, Hotchkiss R, Levy M, Marshall J, Martin G, Opal S, Rubenfeld G, van der Poll T, Vincent J, Angus DJJ. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10.CrossRef Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard G, Chiche J, Coopersmith C, Hotchkiss R, Levy M, Marshall J, Martin G, Opal S, Rubenfeld G, van der Poll T, Vincent J, Angus DJJ. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10.CrossRef
20.
go back to reference Shi SH, Zhai ZL, Zheng SS. Pyogenic liver abscess of biliary origin: the existing problems and their strategies. Semin Liver Dis. 2018;38(3):270–83.CrossRef Shi SH, Zhai ZL, Zheng SS. Pyogenic liver abscess of biliary origin: the existing problems and their strategies. Semin Liver Dis. 2018;38(3):270–83.CrossRef
21.
go back to reference Khim G, Em S, Mo S, Townell N. Liver abscess: diagnostic and management issues found in the low resource setting. Br Med Bull. 2019;132(1):45–52.CrossRef Khim G, Em S, Mo S, Townell N. Liver abscess: diagnostic and management issues found in the low resource setting. Br Med Bull. 2019;132(1):45–52.CrossRef
22.
go back to reference Li Z, Xiao Y, Zhang L. Application of procalcitonin, white blood cell count and neutrophil-to-lymphocyte ratio in the diagnosis of systemic lupus erythematosus with a bacterial infection. Ann Palliat Med. 2020;9(6):3870–6.CrossRef Li Z, Xiao Y, Zhang L. Application of procalcitonin, white blood cell count and neutrophil-to-lymphocyte ratio in the diagnosis of systemic lupus erythematosus with a bacterial infection. Ann Palliat Med. 2020;9(6):3870–6.CrossRef
24.
go back to reference Kong T, Park YS, Lee HS, Kim S, Lee JW, You JS, Chung HS, Park I, Chung SP. The delta neutrophil index predicts the development of in-hospital hypotension in initially stable patients with pyogenic liver abscess. Sci Rep. 2019;9(1):12105.CrossRef Kong T, Park YS, Lee HS, Kim S, Lee JW, You JS, Chung HS, Park I, Chung SP. The delta neutrophil index predicts the development of in-hospital hypotension in initially stable patients with pyogenic liver abscess. Sci Rep. 2019;9(1):12105.CrossRef
25.
go back to reference Park KS, Lee SH, Yun SJ, Ryu S, Kim K. Neutrophil-to-lymphocyte ratio as a feasible prognostic marker for pyogenic liver abscess in the emergency department. Eur J Trauma Emerg Surg. 2018;45(2):343–51.CrossRef Park KS, Lee SH, Yun SJ, Ryu S, Kim K. Neutrophil-to-lymphocyte ratio as a feasible prognostic marker for pyogenic liver abscess in the emergency department. Eur J Trauma Emerg Surg. 2018;45(2):343–51.CrossRef
26.
go back to reference Manne BK, Xiang SC, Rondina MT. Platelet secretion in inflammatory and infectious diseases. Platelets. 2017;28(2):155–64.CrossRef Manne BK, Xiang SC, Rondina MT. Platelet secretion in inflammatory and infectious diseases. Platelets. 2017;28(2):155–64.CrossRef
27.
go back to reference Kerrigan SW. The expanding field of platelet-bacterial interconnections. Platelets. 2015;26(4):293–301.CrossRef Kerrigan SW. The expanding field of platelet-bacterial interconnections. Platelets. 2015;26(4):293–301.CrossRef
28.
go back to reference Zuchtriegel G, Uhl B, Puhr-Westerheide D, Pörnbacher M, Lauber K, Krombach F, Reichel C. Platelets guide leukocytes to their sites of extravasation. PLoS Biol. 2016;14(5): e1002459.CrossRef Zuchtriegel G, Uhl B, Puhr-Westerheide D, Pörnbacher M, Lauber K, Krombach F, Reichel C. Platelets guide leukocytes to their sites of extravasation. PLoS Biol. 2016;14(5): e1002459.CrossRef
29.
go back to reference Russwurm S, Vickers J, Meier-Hellmann A, Spangenberg P, Bredle D, Reinhart K, Lösche W. Platelet and leukocyte activation correlate with the severity of septic organ dysfunction. Shock. 2002;17(4):263–8.CrossRef Russwurm S, Vickers J, Meier-Hellmann A, Spangenberg P, Bredle D, Reinhart K, Lösche W. Platelet and leukocyte activation correlate with the severity of septic organ dysfunction. Shock. 2002;17(4):263–8.CrossRef
31.
go back to reference Li Y, Zou ZP, Zhang YL, Zhu BW, Ning YC, Shen B, Wang CS, Luo Z, Xu JR, Ding XQ. Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery. Ren Fail. 2021;43(1):1012–9.CrossRef Li Y, Zou ZP, Zhang YL, Zhu BW, Ning YC, Shen B, Wang CS, Luo Z, Xu JR, Ding XQ. Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery. Ren Fail. 2021;43(1):1012–9.CrossRef
32.
go back to reference Meyer J, Lejmi E, Fontana P, Morel P, Gonelle-Gispert C, Bühler L. A focus on the role of platelets in liver regeneration: Do platelet-endothelial cell interactions initiate the regenerative process? J Hepatol. 2015;63(5):1263–71.CrossRef Meyer J, Lejmi E, Fontana P, Morel P, Gonelle-Gispert C, Bühler L. A focus on the role of platelets in liver regeneration: Do platelet-endothelial cell interactions initiate the regenerative process? J Hepatol. 2015;63(5):1263–71.CrossRef
34.
go back to reference Gameiro J, Fonseca JA, Dias JM, Milho J, Rosa R, Jorge S, Lopes JA. Neutrophil, lymphocyte and platelet ratio as a predictor of postoperative acute kidney injury in major abdominal surgery. BMC Nephrol. 2018;19(1):320.CrossRef Gameiro J, Fonseca JA, Dias JM, Milho J, Rosa R, Jorge S, Lopes JA. Neutrophil, lymphocyte and platelet ratio as a predictor of postoperative acute kidney injury in major abdominal surgery. BMC Nephrol. 2018;19(1):320.CrossRef
35.
go back to reference Koo CH, Eun Jung D, Park YS, Bae J, Cho YJ, Kim WH, Bahk JH. Neutrophil, lymphocyte, and platelet counts and acute kidney injury after cardiovascular surgery. J Cardiothorac Vasc Anesth. 2018;32(1):212–22.CrossRef Koo CH, Eun Jung D, Park YS, Bae J, Cho YJ, Kim WH, Bahk JH. Neutrophil, lymphocyte, and platelet counts and acute kidney injury after cardiovascular surgery. J Cardiothorac Vasc Anesth. 2018;32(1):212–22.CrossRef
36.
go back to reference Patel H, Srinivasa DR, Volod O, Wang ED, Kim EA. Rotational thromboelastometry derivative fibrinogen-platelet ratio predicts thrombosis in microsurgery. J Reconstr Microsurg. 2021;37(9):774–82.CrossRef Patel H, Srinivasa DR, Volod O, Wang ED, Kim EA. Rotational thromboelastometry derivative fibrinogen-platelet ratio predicts thrombosis in microsurgery. J Reconstr Microsurg. 2021;37(9):774–82.CrossRef
Metadata
Title
Prognostic value of platelet count-related ratios on admission in patients with pyogenic liver abscess
Authors
Shixiao Li
Sufei Yu
Jiajia Qin
Minfei Peng
Jiao Qian
Peng Zhou
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07613-x

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