Predictive Values of Platelets Count and Spleen Diameter in the Diagnosis of Esophageal Varices in Black African Cirrhotic Patients

Background: Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. Purpose: To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. Material and Method: This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. Results: The study included 101 patients;they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93;92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65;78.3%), hepatitis C virus (HCV) (n = 21;25, 3%), and alcohol (n = 6;7.2%). Platelet count (PC) < 100,000/mm3 was statistically related to the presence of OV with red signs. Splenomegaly (SD > 130 mm) and PC/SD ratio < 1000 were significantly related to the presence of OVs and large OVs. SD with a cutoff of > 102 mm predicted 75% of OVs (AUROC = 0.797). CP with a cutoff < 131,000/mm3, predicted 100% of OVs (AUROC = 0.756). The PC/SD ratio < 1205 diagnosed 100% of OV (AUROC = 0.801). The PC/SD ratio < 818 and SD > 129 mm predicted large OVs. Conclusion: Platelet count, spleen diamater, and PC/SD ratio were all performant for the diagnosis of OVs in our setting with better diagnostic performance for PC/SD. This report could help initiate prophylactic treatment for OVs rupture in cirrhotic patients in health centers where gastrointestinal endoscopy is lacking.

Platelet counts to spleen diameter ratio:A promising noninvasive tool for predicting esophageal varices in cirrhosis patients

BACKGROUND Liver cirrhosis is the end stage of progressive liver fibrosis as a consequence of chronic liver inflammation,wherein the standard hepatic architecture is replaced by regenerative hepatic nodules,which eventually lead to liver failure.Cirrhosis without any symptoms is referred to as compensated cirrhosis.Complications such as ascites,variceal bleeding,and hepatic encephalopathy indicate the onset of decompensated cirrhosis.Gastroesophageal varices are the hallmark of clini-cally significant portal hypertension.AIM To determine the accuracy of the platelet count-to-spleen diameter(PC/SD)ratio to evaluate esophageal varices(EV)in patients with cirrhosis.METHODS This retrospective observational study was conducted at Tikur Anbessa Specia-lized Hospital and Adera Medical Center from January 1,2019,to December 30,2023.Data were collected via chart review and direct patient interviews using structured questionnaires.The data were exported to the SPSS software version 26 for analysis and clearance.A receiver operating characteristic curve was plotted for splenic diameter,platelet count,and PC/SD ratio to obtain sensitivity,speci-ficity,positive predictive value,negative predictive value,positive likelihood ratio,and negative likelihood ratio.RESULTS Of the 140 participants,67%were men.Hepatitis B(38%)was the most common cause of cirrhosis,followed by cryptogenic cirrhosis(28%)and hepatitis C(16%).Approximately 83.6%of the participants had endoscopic evidence of EV,whereas 51.1%had gastric varices.Decompensated cirrhosis and PC were associated with the presence of EV with adjusted odds ratios of 12.63(95%CI:3.16-67.58,P=0.001)and 0.14(95%CI:0.037-0.52,P=0.004),respectively.A PC/SD ratio<1119 had a sensitivity of 86.32%and specificity of 70%with area under the curve of 0.835(95%CI:0.736-0.934,P<0.001).CONCLUSION A PC/SD ratio<1119 predicts EV in patients with cirrhosis.It is a valuable,noninvasive tool for EV risk assess-ment in resource-limited settings.

Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer

BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods,some patients with early CRC still experience postoperative recurrence and metastasis.AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study.Results of blood routine test,liver and kidney function tests and tumor markers were collected before surgery.Patients were followed up through disease-specific database and telephone interviews.Tumor recurrence,metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.RESULTS We comprehensively compared the predictive value of preoperative blood routine,blood biochemistry and tumor markers for disease-free survival(DFS)and overall survival(OS)of CRC.Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS[hazard ratio(HR)=0.995,95% confidence interval(CI):0.991-0.999,P=0.015],while serum carcinoembryonic antigen(CEA)level(HR=1.008,95%CI:1.001-1.016,P=0.027)and serum total cholesterol level(HR=1.538,95%CI:1.026-2.305,P=0.037)were independent risk factors for OS.The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL.Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level,the difference between the two groups was not statistically significant(P=0.075).CONCLUSION For patients with T2N0M0 or T3N0M0 CRC,preoperative platelet count was a protective factor for DFS,while serum CEA level was an independent risk factor for OS.Given that these measures are easier to detect and more acceptable to patients,they may have broader applications.

Predictive value of thrombocytopenia for bloodstream infection in patients with sepsis and septic shock

BACKGROUND Thrombocytopenia is common in patients with sepsis and septic shock.AIM To analyse the decrease in the number of platelets for predicting bloodstream infection in patients with sepsis and septic shock in the intensive care unit.METHODS A retrospective analysis of patients admitted with sepsis and septic shock in Xingtai People Hospital was revisited.Patient population characteristics and laboratory data were collected for analysis.RESULTS The study group consisted of 85(39%)inpatients with bloodstream infection,and the control group consisted of 133(61%)with negative results or contamination.The percentage decline in platelet counts(PPCs)in patients positive for pathogens[57.1(41.3-74.6)]was distinctly higher than that in the control group[18.2(5.1–43.1)](P<0.001),whereas the PPCs were not significantly different among those with gram-positive bacteraemia,gram-negative bacteraemia,and fungal infection.Using receiver operating characteristic curves,the area under the curve of the platelet drop rate was 0.839(95%CI:0.783-0.895).CONCLUSION The percentage decline in platelet counts is sensitive in predicting bloodstream infection in patients with sepsis and septic shock.However,it cannot identify gram-positive bacteraemia,gram-negative bacteraemia,and fungal infection.

Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis

AIM: To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.

Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count

AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.

Low preoperative platelet counts predict a high mortality after partial hepatectomy in patients with hepatocellular carcinoma

AIM： To assess the validity of our selection criteria for hepatectomy procedures based on indocyanine green disappearance rate （KICG）, and to unveil the factors affecting posthepatectomy mortality in patients with hepatocellular carcinoma （HCC）. METHODS： A retrospective analysis of 198 consecutive patients with HCC who underwent partial hepatectomies in the past 14 years was conducted. The selection criteria for hepatectomy procedures during the study period were KICG≥0.12 for hemihepatectomy, KICG≥0.10 for bisegmentectomy, KCG≥0.08 for monosegmentectomy, and KICG≥ 0.06 for nonanatomic hepatectomy. The hepatectomies were categorized into three types： major hepatectomy （hemihepatectomy or a more extensive procedure）, bisegmentectomy, and limited hepatectomy. Univariate （Fishers exact test） and multivariate （the logistic regression model） analyses were used. RESULTS： Postoperative mortality was 5% after major hepatectomy, 3% after bisegmentectomy, and 3% after limited hepatectomy. The bhree percentages were comparable （P = 0.876）. The platelet count of ≤ 10× 10^4/μL was the strongest independent factor for postoperative mortality on univariate （P = 0.001） and multivariate （risk ratio, 12.5; P= 0.029） analyses. No patient with a platelet count of 〉7.3× 10^4/μL died of postoperative morbidity, whereas 25% （6/24 patients） of patients with a platelet count of ≤7.3×10^4/μL died （P〈0.001）. CONCLUSION： The selection criteria for hepatectomy procedures based on KICG are generally considered valid, because of the acceptable morbidity and mortality with these criteria. The preoperative platelet count independently affects morbidity and mortality after hepatectomy, suggesting that a combination of KICG and platelet count would further reduce postoperative mortality.

Association between baseline platelet count and severe adverse outcomes following percutaneous coronary intervention

Objective The aim is to evaluate the association between baseline platelet count （PC） and severe adverse outcomes following percu- taneous coronary intervention （PCI） in current real-world practice. Methods A total of 18,788 patients underwent PCI with drug-eluting stents constituted the study population. Patients were categorized as having low （〈 150 × 1000μ.L）, normal （150-300 × 1000μL）, and high （≥ 300 × 1000μL） baseline PC. The primary endpoints included in-hospital and follow-up all-cause mortality. The secondary endpoint was major bleeding requiring a blood transfusion. Results In-hospital mortality rates for patients with low, normal, and high baseline PC were 0.6%, 0.4%, and 0.4%, respectively （P = 0.259）. Similarly, mortality rates during long-term follow-up （median 23.8 months） for patients with low, normal, and high baseline PC were 0.9%, 0.6%, and 0.7%, respectively （P = 0.079）. After multivariate adjustment, patients with low or high baseline PC tended to have similar risks for both in-hospital and follow-up mortality compared with the normal group. Subgroup analyses failed to demonstrate an independent prognostic value of baseline PC in specific population groups except patients who undwent transfemoral PCI. There was also no significant difference in the incidence of major bleeding requiring a blood transfusion in the low, normal, and high groups （0.5%, 0.3%, and 0.3%, respectively; P = 0.320）. After multivariate adjustment, low or high baseline PC did not signi- ficantly increase the risk of major bleeding. Conclusion There is no significant association between baseline PC and severe adverse out- comes following PCI in current real-world practice.

Longitudinal changes in personalized platelet count metrics are good indicators of initial 3-year outcome in colorectal cancer

BACKGROUND Platelet count or complete blood count(CBC)-based ratios including lymphocyteto-monocyte(LMR),neutrophil-to-lymphocyte(NLR),hemoglobin-to-platelet(HPR),red blood cell count distribution width-to-platelet(RPR),and platelet-tolymphocyte(PLR)ratio are good predictors of colorectal cancer(CRC)survival.Their change in time is not well documented,however.AIM To investigate the effect of longitudinal CBC ratio changes on CRC survival and their possible associations with clinicopathological properties,comorbidities,and anamnestic data.METHODS A retrospective longitudinal observational study was conducted with the inclusion of 835 CRC patients,who attended at Semmelweis University,Budapest.CBC ratios and two additional newly defined personalized platelet count metrics(pPLT_(D)and pPLT_(S),the platelet counts relative to the measurement at the time of CRC diagnosis and to the one 4-6 wk after tumor removal surgery,respectively)were recorded.RESULTS The 835 CRC patients had a total of 4608 measurements(5.52 visits/patient,in average).Longitudinal survival models revealed that the increases/decreases in LMR[hazard ratio(HR):0.4989,P<0.0001],NLR(HR:1.0819,P<0.0001),HPR(HR:0.0533,P=0.0038),pPLT_(D)(HR:4.9229,P<0.0001),and pPLT_(S)(HR:4.7568,P<0.0001)values were poor prognostic signs of disease-specific survival.The same was obtained for all-cause mortality.Most abnormal changes occurred within the first 3 years after the diagnosis of CRC.RPR and PLR had an only marginal effect on diseasespecific(P=0.0675)and all-cause mortality(Bayesian 95%credible interval:0.90–186.05),respectively.CONCLUSION LMR,NLR,and HPR are good metrics to follow the prognosis of the disease.pPLT_(D)and pPLT_(S)perform just as well as the former,while the use of RPR and PLR with the course of the disease is not recommended.Early detection of the abnormal changes in pPLT_(D),pPLT_(S),LMR,NLR,or HPR may alert the practicing oncologist for further therapy decisions in a timely manner.

The Pattern of Eosinophil Count among Nigerians with Frequent Use of the Commonly Available Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) use is very common. NSAIDs use could be associated with elevated eosinophil count which could be a class effect or patient-related. Inflammation could be the link between NSAIDs use and eosinophilia. Aims: To compare the pattern of eosinophil count in the peripheral blood of frequent users of NSAIDs and healthy controls. Methodology: Two hundred (one hundred frequent users of NSAIDs and 100 healthy controls) participants who had no known risk factor for kidney disease and had given informed consent were recruited. Blood was taken to determine the white cell count and differentials, serum electrolyte and creatinine, and random blood sugar. Results: The mean age of NSAIDs users was not significantly different from controls, P = 0.3. The mean eosinophil count was higher in males than females. The incidence of eosinophilia in NSAIDs users was 4%. The mean Eosinophil count of NSAIDs users was insignificantly higher than controls, 164.3 ± 51 6 vs 135. 6 ± 53.4, P = 0.4. The mean platelet count of NSAIDs users was significantly higher compared to controls, P = 0.04. The mean hematocrit of NSAIDs users was significantly lower than the controls, P = 0.02. Propionic acid derivatives were associated with the highest eosinophil count. Eosinophil count was positively related to age and serum creatinine and inversely related to blood glucose, hematocrit and glomerular filtration rate. Conclusion: The incidence of eosinophilia was 4%. The eosinophil count was higher in frequent NSAIDs users than occasional and non-users, in males than females and with use propionic acid derivatives compared to other NSAIDs. The Eosinophil count was positively related to age and platelet count. Being commoner in inflammatory states, the tissue destruction associated with elevated EC can be avoided by the prevention and prompt treatment of inflammatory conditions.

Relationship between platelet count and gastric cancer stage and prognosis

Objective:The aim of the research was to investigate the relationship between gastric cancer stage, prognosis and blood platelets count. Methods: Platelet (PLT) count was analyzed retrospectively in 203 patients with gastric cancer from 1998 to 2002. The survivals of gastric cancer were compared between normal PLT group and thrombocytosis group. Results: Among 203 cases, PLT increased in 21 cases. The average platelet counts of patients at different stages had statistically significant differences (P<0.01). The 3-and 5-year survivals in patients of thrombocytosis group were lower than those of the normal PLT group (P<0.01). Conclusion: Thrombocytosis in gastric cancers with advanced stage are common. And PLT count can be a prognostic indicator of survival in patients with gastric cancer undergoing gastrectomy.

Platelet count reduction and outcomes in living liver donors

BACKGROUND: Platelet count reduction in living donors after graft harvesting is very common. The mechanisms and the subsequent adverse consequences are not clear. The present study was to explore the mechanisms and the consequences of platelet count reduction in living donors. METHODS: We collected data from 231 living liver donor patients who donated at our transplant center between July 2002 and August 2009. Baseline and post-operative platelet counts were collected and analyzed. Multivariate logistic regression analysis was used to compare the risk factors for the persistent decrease in platelet counts. Complications and other postoperative recovery were compared between the donors. RESULTS: Platelet count decreased differently at each of the follow-up intervals, and the average reduction from baseline evaluation to year 3 was 18.2%. A concomitant decrease in white blood cells was observed with platelet count reduction. All of the splenic volumes at the post-operative follow-up time points were significantly higher than those at baseline(P【0.01). Multivariate logistic regression analysis indicated that the graft-to-donor weight ratio was a risk factor for low postoperative platelet counts in living donors at the three followup time points: one week(P=0.047), one month(P=0.034), and three months(P=0.047). At the one week follow-up time, 77 donor platelet counts were higher(group 1) and 151 donor platelet counts were lower(group 2) than baseline levels. Two hemorrhage events(1.3%) were observed in group 2, while three hemorrhage events(3.9%) were observed in group 1(P=0.211). The overall complication rate was comparable between the two groups(P=0.972). CONCLUSION: An increase in harvesting graft may decrease platelet counts, but this reduction does not produce short- or long-term damage in living liver donors.

Combination of type Ⅳ collagen 7S, albumin concentrations, and platelet count predicts prognosis of non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common cause of chronic liver disease and affects approximately 25%of the general global adult population.The prognosis of NAFLD patients with advanced liver fibrosis is known to be poor.It is difficult to assess disease progression in all patients with NAFLD;thus,it is necessary to identify patients who will show poor prognosis.AIM To investigate the efficacy of non-invasive biomarkers for predicting disease progression in patients with NAFLD.METHODS We investigated biomarkers associated with mortality in patients with NAFLD who visited the Kawasaki Medical School General Medical Center from 1996 to 2018 and underwent liver biopsy and had been followed-up for>1 year.Cumulative overall mortality and liver-related events during follow-up were calculated using the Kaplan-Meier analysis and compared using log-rank testing.We calculated the odds ratio and performed receiver operating characteristic curve analysis with logistic regression analysis to determine the optimal cut-off value with the highest prognostic ability.RESULTS We enrolled 489 patients who were followed-up for a period of 1-22.2 years.In total,13 patients died(2.7%of total patients enrolled);7 patients died due to liverrelated causes.Poor prognosis was associated with liver fibrosis on histological examination but not with inflammation or steatosis.Blood biomarkers associated with mortality were platelet counts,albumin levels,and type IV collagen 7S levels.The optimal cutoff index for predicting total mortality was a platelet count of 15×10^(4)/μL,albumin level of 3.5 g/dL,and type IV collagen 7S level of 5 mg/dL.In particular,only one-factor patients with NAFLD presenting with platelet counts≤15×10^(4)/μL,albumin levels≤3.5 g/dL,or type IV collagen 7S≥5 mg/dL showed 5-year,10-year,and 15-year survival rates of 99.7%,98.3%,and 94%,respectively.However,patients with two factors had lower 5-year and 10-year survival rates of 98%and 43%,respectively.Similarly,patients with all three factors showed the lowest 5-year and 10-year survival rates of 53%and 26%,respectively.CONCLUSION A combination of the three non-invasive biomarkers is a useful predictor of NAFLD prognosis and can help identify patients with NAFLD who are at a high risk of all-cause mortality.

Analysis of prognostic factors in patients with emergency sepsis

BACKGROUND Emergency sepsis is a common and serious infectious disease,and its prognosis is influenced by a number of factors.AIM To analyse the factors influencing the prognosis of patients with emergency sepsis in order to provide a basis for individualised patient treatment and care.By retrospectively analysing the clinical data collected,we conducted a comprehensive analysis of factors such as age,gender,underlying disease,etiology and site of infection,inflammatory indicators,multi-organ failure,cardiovascular function,therapeutic measures,immune status and severity of infection.METHODS Data collection:Clinical data were collected from patients diagnosed with acute sepsis,including basic information,laboratory findings,medical history and treatment options.Variable selection:Variables associated with prognosis were selected,including age,gender,underlying disease,etiology and site of infection,inflammatory indicators,multi-organ failure,cardiovascular function,treatment measures,immune status and severity of infection.Data analysis:The data collected are analysed using appropriate statistical methods such as multiple regression analysis and survival analysis.The impact of each factor on prognosis was assessed according to prognostic indicators,such as survival,length of stay and complication rates.RESULTS Descriptive statistics:Descriptive statistics were performed on the data collected from the patients,including their basic characteristics and clinical presentation.CONCLUSION Type 2 diabetes mellitus were independent factors affecting the prognosis of patients with sepsis.

Factors Predicting Transformation of Non-Severe Pre-Eclampsia into Pre-Eclampsia with Severe Features

Background: Pre-eclampsia (PE), a complex, multisystem, pregnancy-associated hypertensive disorder, typically developing after the 20th week of gestation, that complicates 2% - 8% of pregnancies, is a leading cause of neonatal and maternal mortality and morbidity. Aim of the Work: To identify different factors predicting transformation of non-severe pre-eclampsia in to pre-eclampsia with severe features. Patients and Methods: This prospective cohort study was conducted at tertiary care hospital at Ain Shams University hospitals from June 2021 till January 2022 and performed on total of 100 patients who diagnosed as non-severe pre-eclampsia after exclusion of severity features. Results: The current study revealed that transformation to severe pre-eclampsia occurred in 33% of the studied cases. Body mass index (BMI), past and family histories of preeclampsia statistically were significantly higher in cases transformed into preeclampsia with severe features. Admission blood pressure, albumin dipstick, Oligohydramnios and IUGR statistically were significantly higher in cases with transformation from non-severe pre-eclampsia into pre-eclampsia with severe features. Platelet count statistically was significantly lower in cases with transformation from non-severe pre-eclampsia into pre-eclampsia with severe features Conclusion: Our study results identified the most important clinical risk factors for transformation to severe features of pre-eclampsia from non-severe features and provided new information on the level of risk associated with specific combinations of risk factors (BMI ≥ 35.4, admission systolic blood pressure, admission diastolic blood pressure, albumin dipstick 4+ and platelets count) with low significant diagnostic performance in predicting transformation from non-severe pre-eclampsia into pre-eclampsia with severe features.

Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism

AIM:To evaluate whether total splenic artery embolization(TSAE) for patients with hypersplenism delivers better long-term outcomes than partial splenic embolization(PSE).METHODS:Sixty-one patients with hypersplenism eligible for TSAE(n = 27,group A) or PSE(n = 34,group B) were enrolled into the trial,which included clinical and computed tomography follow-up.Data on technical success,length of hospital stay,white blood cell(WBC) and platelet(PLT) counts,splenic volume and complications were collected at 2 wk,6 mo,and 1,2,3,4 years postoperatively.RESULTS:Both TSAE and PSE were technically successful in all patients.Complications were significantly fewer(P = 0.001),and hospital stay significantly shorter(P = 0.007),in group A than in group B.Postprocedure WBC and PLT counts in group A were significantly higher than those in group B from 6 mo to 4 years(P = 0.001),and post-procedure residual splenic volume in group A was significantly less than that observed in group B at 1,2,3 and 4 years post-procedure(P = 0.001).No significant differences were observed in red blood cell counts and liver function parameters between the two groups following the procedure.CONCLUSION:Our results indicate that TSAE for patients with hypersplenism not only delivers a better longterm outcome,but is also associated with lower complication rates and a shorter hospital stay than PSE.

Close Correlation between Development of MODS during the Initial 72h of Hospitalization and Hospital Mortality in Severe Fever with Thrombocytopenia Syndrome

An emerging infectious disease was identified as severe fever with thrombocytopenia syn- drome （SFTS） in central China since late March 2009. We found the patients with SFTS had severe clinical symptoms, and progressed rapidly to multiple organ dysfunction syndrome （MODS） with high fatality rate of 25%-30%. The aim of this study was to assess the significance of risk factors predicting the development of MODS and death in SFTS patients. Consecutive SFTS admissions between May 2009 and September 2011 were analyzed for parameters of organ function during hospitalization using Marshall scoring system for MODS, and platelet counts were recorded on admission and at 24, 48, 72 h and one week after admission. We investigated the kinetics of organ failures and analyzed the associa- tion between age, platelet count and development of MODS or death. A total of 92 SFTS patients were enrolled in this study. Among them, 32 patients with dysfunction of over 4 organs were identified, 45% of them died within 72 h, 72% died within 5 days, and 76% died within 7 days after admission. We also found cumulative Marshall score was significantly higher in death patients （11.76＋2.05） than in survival patients （4.22~1.98） （P〈0.001）. In addition, SFTS patients had older age and lower platelet counts in MODS and death groups. Furthermore, we also observed that there was a close correlation between platelet count on admission and Marshall score （P〈0.001）. High Marshall score, advanced age and lower platelet counts were the main risk factors for the development of MODS, and those factors could predict mortality in SFTS patients, suggesting prompt treatment and close monitoring of severe complications, especially MODS, are of great importance in saving patients＇ lives.

Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura

AIM: To assess the effect of Helicobacter pylori (H. pylori) eradication on platelet counts in patients with chronic immune thrombocytopenic purpura (cITP).

Helicobacter pylori infection in patients with autoimmune thrombocytopenic purpura

AIM:To compare the prevalence of Helicobacter pylori (Hpylon)infection in autoimmune thrombocytopenic purpura (AITP)patients with that of nonthrombocytopenic controls, and to evaluate the efficacy of the treatment in H pylori(+) and H pylor(-)AITP patients. METHODS:The prevalence of gastric H pylori infection in 38 adult AITP patients(29 female and 9 male;median age 27 years;range 18-39 years)who consecutively admitted to our clinic was investagated. RESULTS:H pylori infection was found in 26 of 38 AITP patients(68.5%).H pylori infection was found in 15 of 23 control subjects(65.2%).The difference in H pylori infection between the 2 groups was not significant.Thrombocyte count of H pylori-positive AITP patients was significantly lower than that of H pylori-negative AITP patients(P<0.05). Thrombocyte recovery of H pylori-positive group was less than that of H pylori-negative group(P<0.05). CONCLUSION:H pylori infection should be considerecd in the treatment of AITP patients with H pylori infection.