Diagnostic value of thrombocytosis in the infectious intraabdominal collection as a postsurgical complication

Abstract

Introduction: The diagnosis of post-surgical intraabdominal collections (PSIC) is difficult because of the non-specific clinic. For this we rely on vital signs, exploration, laboratory tests and imaging. The most used biomarkers are leukocytosis with neutrophilia, C-reactive protein or procalcitonin. The platelets can also increase their value because inflammatory factors are involved in thrombopoyesis.

Objective: To determine the internal validity of thrombocytosis in the diagnosis of PSIC.

Material and Methods: Re-trospective observational study conducted on patients who underwent surgery between January 2021 and December 2023 who developed a PSIC confirmed by CT and percutaneously drained (Group PSIC), and others operated without post-surgical collection (group NoPSIC).

Results: We analyzed 120 patients: 60 group with PSIC and 60 without. They were comparable in terms of demographic variables and morbidity. In univariate analysis, thrombocytosis showed an OR 27.34 (3.52-212.3; p = 0.002). In addition, it presents the largest area under the curve of the analyzed parameters, AUC: 0.803 (0.727-0.880; p = 0.000). Throm-bocytosis has a sensitivity of 95% and specificity of 59% for the diagnosis of PSIC. Being the positive plausibility reason of 2,317 and negative reason of 0.0847.

Conclusions The absence of thrombocytosis (≥ 450.000/μl) allows the diagnosis of PSIC to be ruled out with high security. Being almost 12 times more likely that thrombocytosis is absent in a healthy than in a patient with a collection. With these results we proposed the need for prospective studies to contrast these findings.