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Updated: Oct 23, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Lower platelet counts were associated with 90-day adverse outcomes in acute-on-chronic liver disease patients
Renjie Ouyang1, Hai Li2, Jie Xia3
1Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Hepatology, Chenzhou No. 1 People's Hospital, Chenzhou, China.
Insights
Lower platelet counts in patients with acute-on-chronic liver diseases (AoCLD) indicate a higher risk of 90-day adverse outcomes, including death or liver transplantation. This association holds even within the normal platelet range.
Area of Science:
- Hepatology
- Clinical Prognostics
- Hematology
Background:
- Chronic liver diseases (CLD) pose a significant global health burden.
- Platelet count serves as an accessible prognostic indicator for liver disease.
- Acute-on-chronic liver diseases (AoCLD) represent a critical clinical scenario.
Purpose of the Study:
- To investigate the association between platelet count and 90-day prognosis in patients with AoCLD.
- To determine if platelet count predicts adverse outcomes such as death or liver transplantation.
- To assess the prognostic value of platelet count across different ranges, including within normal limits.
Main Methods:
- Analysis of 3,939 patients with AoCLD from the CATCH-LIFE study (two prospective multi-center cohorts).
- Patients were stratified into groups based on platelet count.
- Evaluation of 90-day adverse outcomes, defined as death or liver transplantation.
Main Results:
- A significant inverse association was found between platelet count and 90-day adverse outcomes (P for trend <0.001).
- Patients with platelet counts <20×10^9/L exhibited the highest risk (OR, 3.15).
- A 5% increased risk of adverse outcomes was observed for every 10×10^9/L decrease in platelet count below 210×10^9/L.
Conclusions:
- Lower platelet counts are strongly associated with increased 90-day adverse outcomes in AoCLD patients.
- Prognostic risk increases even with decreasing platelet counts within the normal range.
- Platelet count is a valuable and accessible prognostic marker for AoCLD.
Background:
Chronic liver diseases (CLD), including cirrhosis and non-cirrhotic liver diseases, are globally widespread and create a serious disease burden. Platelet count is a clinically accessible and affordable prognostic indicator of liver disease. We investigated the relationship between platelet count and 90-day prognosis in patients with acute-on-chronic liver diseases (AoCLD).
Methods:
A total of 3,970 patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure (CATCH-LIFE) study, which included two prospective multi-center cohorts, were included in the study. We grouped the patients according to the platelet count and analyzed the 90-day adverse outcome (death or liver transplantation).
Results:
In the final analysis, 3,939 patients with AoCLD were included, of whom 2,802 had definite liver cirrhosis. The cumulative incidence of 90-day adverse outcomes in patients increased with the change of platelet group (log-rank P<0.001). From univariate and multivariate analyses, platelet count was inversely associated with the incidence of 90-day adverse outcomes in patients (P for trend <0.001). The group with platelet count <20×109/L had the highest risk (odds ratio, 3.15; 95% confidence interval, 1.59-6.25), with 21 (36.8%) of these patients having adverse outcomes within 90 days. The risk of a 90-day adverse outcome in patients increased by 5% for every 10×109/L decrease in platelet count below 210×109/L.
Conclusions:
Lower platelet count was associated with a higher incidence of 90-day adverse outcomes in patients with AoCLD. Even within the normal platelet count range, the risk of a 90-day adverse outcome in patients increased with decreases in platelet count.
Trial Registration:
NCT02457637, NCT03641872.
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