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Poster Networking

Platelets and Megakaryocytes

PB0744 - Platelet-leucocyte aggregates are predictor of postoperative infection in patients with rheumatic heart disease

Monday, June 24, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall

    Presenting Author(s)

  • Chaonan Liu, MD

    None
    West China Hospital, Sichuan University
    Chengdu, Sichuan, China (People's Republic)

    • Co-Author(s)

  • JZ

    Jinghan Zhang

    None
    .Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu, China
    Chengdu, Sichuan, China (People's Republic)

  • CT

    Chuanmin Tao

    professor
    Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
    Chengdu, Sichuan, China (People's Republic)

  • JZ

    Jing Zhou

    Professor
    West China Hospital, Sichuan University
    Chengdu, Sichuan, China (People's Republic)

  • DG

    Daming Gou

    professor
    Department of Anesthesiology,Guizhou Maotai Hospital
    Zunyi, Guizhou, China (People's Republic)

Background: Infection is one of the common complications after surgery. Currently indicators usually not fluctuate significantly unless infection has progressed. They cannot be used to predict infection early.Platelet-leukocyte aggregates (PLA) play a role in physiological mechanisms. Meanwhile, they are good predictors of inflammation.

Aims: To explore whether PLA could be an effective indicator for the early prediction of postoperative infection.

Methods: Patients with rheumatic heart disease who were to undergo valve replacement surgery at West China Hospital of Sichuan University between November, 2011,and September, 2012 were enrolled, and the occurrence of infection during the peri-CPB and follow-up periods was recorded. Blood samples were collected at five time points: (1) baseline-before surgery; (2) end of CPB; (3) arrival at the ICU; (4) admission to the ICU for 4hs; (5) admission to the ICU for 20hs.PLA, IL-8 and TNF-α were determined at each time point.

Results: A total of 244 patients were enrolled in this study. The incidence of infection in the peri-CPB period and three-year follow-up period was significantly higher,when patients had low PLA levels (PLA≤5.8%) or high PLA levels (PLA≥21.0%). In contrast, the incidence of infection was significantly lower in patients with PLA between 5.8 and 21.0%. Further analysis showed that high PLA was an independent risk factor for infection. The incidence of perioperative infection in the high-PLA (PLA>21.0%) group was 4.103 times higher than in the low PLA group (between 5.8 and 21.0%; P=0.211). During the follow-up period, the likelihood of infection in the high-PLA group was 3.988 times greater than that in the middle-PLA group. (P=0.014). Neither IL-8 nor TNF-α was predictive of perioperative infection.

Conclusion(s): Too low or too high PLA levels increase the risk of infection, and PLA is an independent risk factor for the occurrence of infection in the follow-up period.