Platelet Count as an Indicator of Ovarian Malignancy in Women With Ascites [ID 1509]

INTRODUCTION: Ascites, characterized by pathological fluid accumulation in the peritoneal cavity, is primarily associated with liver cirrhosis, but 10% of cases are attributed to cancer etiology. Thrombocytopenia, common in cirrhotic patients, contrasts with thrombocytosis observed in gynecologic cancers. This study explores the utility of platelet counts in distinguishing between malignant and cirrhotic ascites, aiming to expedite accurate diagnoses. METHODS: A retrospective chart review was conducted from January 2019 to May 2023 using electronic health records (EHR) from UMC Health System. Selection criteria were based on Current Procedural Terminology (CPT) and ICD-10 codes. Inclusion criteria involved age (18–89), ascites diagnosis, and recorded platelet, albumin, and prothrombin time levels. Data analysis employed STATA 17.0, including logistic regression and ROC curve analysis. RESULTS: Analysis of 109 patient charts revealed a significant association between platelet counts greater than 350,000/microliter and malignant ascites (47.3% versus 12.9%, P =.000). Median prothrombin time was higher in nonmalignant cases (15.4 versus 14.2, P =.011). Platelet counts greater than 250,000 exhibited optimal discriminatory power for malignant ascites, with notable sensitivity, specificity, and predictive values. CONCLUSIONS/IMPLICATIONS: This retrospective exploratory analysis suggests that elevated platelet counts, especially above 250,000/microliter, may serve as a valuable screening tool for distinguishing between malignant and cirrhotic ascites in women. Implementing a platelet count cutoff could aid in expediting accurate diagnoses, reducing the need for invasive and costly tests.