Value of baseline platelet count for prediction of complications in primary biliary cirrhosis patients treated with ursodeoxycholic acid

Abstract

Background. Decreased platelet count has been observed in various liver diseases, but its significance in primary biliary cirrhosis (PBC) remains unknown. The present study aimed to evaluate the predictive value of the platelet count at diagnosis for PBC-related complications in patients newly diagnosed with PBC and treated with ursodeoxycholic acid (UDCA). Methods. Ninety-six PBC patients without complications treated with UDCA immediately after diagnosis were retrospectively reviewed. All hematologic and chemical parameters, Mayo risk score and PBC-related complications including upper gastrointestinal hemorrhage, presence of ascites, serum bilirubin concentration > 102.6 μmol/L and onset of hepatic encephalopathy were extracted. The associations between these parameters at diagnosis and complications were determined and the prognostic value of the platelet count was evaluated by receiver operating characteristics (ROC) analysis, Kaplan-Meier method and Cox proportional hazard model with the hazard ratio (HR) and 95% confidence interval (CI) calculated. Results. Patients with PBC-related complications had significantly decreased platelet count and serum bilirubin concentration, prolonged prothrombin time, and increased Mayo risk score compared to those without complications. A platelet count of ≤ 132.5 × 10⁹/L was associated with the occurrence of complications, with an area under the ROC curve of 0.74 (95% CI: 0.64–0.85). The association remained even after adjustment for Mayo risk score (HR: 2.85; 95% CI: 1.46–5.54; p < 0.01), as shown in the Cox proportional hazard model. Conclusions. Decreased platelet count is a predictive factor for PBC-related complications. A cut-off value of ≤ 132.5 × 10⁹/L is recommended for the baseline platelet count to predict complications in patients newly diagnosed with PBC and treated with UDCA.

Key Words::

• Primary biliary cirrhosis
• platelet count
• Mayo risk score
• complications
• prognosis

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This study was supported by grants from the National Science Foundation of China (30772017, 30770997, 30972730, and 81072479) and the Shanghai Municipal Commission for Science and Technology (09JC1405400). We thank Medjaden Bioscience Limited for assisting in the preparation of the manuscript.