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Risk stratification and outcomes of intracranial hemorrhage in patients with immune thrombocytopenia under 60 years of age

机译：60岁以下免疫血小板减少症患者颅内出血的风险分层及结果

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摘要

Intracranial hemorrhage (ICH) is a devastating complication of immune thrombocytopenia (ITP). However, information on ICH in ITP patients under the age of 60 years is limited, and no predictive tools are available in clinical practice. A total of 93 adult patients with ITP who developed ICH before 60 years of age were retrospectively identified from 2005 to 2019 by 27 centers in China. For each case, 2 controls matched by the time of ITP diagnosis and the duration of ITP were provided by the same center. Multivariate analysis identified head trauma (OR = 3.216, 95%CI 1.296-7.979,P=.012), a platelet count <= 15,000/mu L at the time of ITP diagnosis (OR = 1.679, 95%CI 1.044-2.698,P=.032) and severe/life-threatening bleeding (severe bleedingvs. mild bleeding, OR = 1.910, 95%CI 1.088-3.353,P=.024; life-threatening bleedingvs. mild bleeding, OR = 2.620, 95%CI 1.360-5.051,P=.004) as independent risk factors for ICH. Intraparenchymal hemorrhage (OR = 5.191, 95%CI 1.717-15.692,P=.004) and a history of severe bleeding (OR = 4.322, 95%CI 1.532-12.198,P=.006) were associated with the 30-day outcome of ICH. These findings may facilitate ICH risk stratification and outcome prediction in patients with ITP.
机译：颅内出血（ICH）是免疫性血小板减少症（ITP）的严重并发症。然而，关于60岁以下ITP患者ICH的信息有限，临床实践中没有可用的预测工具。从2005年到2019年，中国27个中心对93名60岁之前发生ICH的成人ITP患者进行了回顾性鉴定。对于每个病例，同一中心提供了两个对照组，其ITP诊断时间和持续时间相匹配。多变量分析确定了头部创伤（OR=3.216，95%可信区间1.296-7.979，P=0.012），ITP诊断时血小板计数<=15000/μL（OR=1.679，95%可信区间1.044-2.698，P=0.032）和严重/危及生命的出血（严重出血、轻度出血，OR=1.910，95%可信区间1.088-3.353，P=0.024；危及生命的出血、轻度出血，OR=2.620，95%可信区间1.360-5.051，P=0.004）是ICH的独立危险因素。脑实质内出血（OR=5.191，95%可信区间1.717-15.692，P=0.004）和严重出血史（OR=4.322，95%可信区间1.532-12.198，P=0.006）与ICH的30天预后相关。这些发现可能有助于ITP患者的ICH风险分层和预后预测。

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  • 来源
    《Platelets》 |2021年第5期|共9页
  • 作者

    Zhao Peng; Hou Ming; Liu Yi; Liu Hui-Xin; Huang Rui-Bin; Yao Hong-Xia; Niu Ting; Peng Jun; Jiang Ming; Han Yan-Qiu; Hu Jian-Da; Zhou Hu; Zhou Ze-Ping; Qiu Lin; Zhang Lian-Sheng; Wang Xin; Wang Hua-Quan; Feng Ru; Yang Lin-Hua; Ma Liang-Ming; Wang Shun-Qing; Kong Pei-Yan; Wang Wen-Sheng; Sun Hui-Ping; Sun Jing; Zhou He-Bing; Zhu Tie-Nan; Wang Li-Ru; Zhang Jing-Yu; Huang Qiu-Sha; LiU Xiao; Fu Hai-Xia; Li Yue-Ying; Wang Qian-Fei; Jiang Qian; Jiang Hao; Lu Jin; Zhang Xiao-Hui;

  • 作者单位

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Shandong Univ Qilu Hosp Dept Hematol Jinan Peoples R China;

    Chinese Peoples Liberat Army Gen Hosp Dept Geriatr Hematol Beijing Peoples R China;

    Peking Univ Dept Clin Epidemiol Peoples Hosp Beijing Peoples R China;

    Nanchang Univ Dept Hematol Affiliated Hosp 1 Nanchang Jiangxi Peoples R China;

    Hainan Gen Hosp Dept Hematol Haikou Hainan Peoples R China;

    Sichuan Univ West China Hosp Dept Hemotol Chengdu Peoples R China;

    Shandong Univ Qilu Hosp Dept Hematol Jinan Peoples R China;

    Xinjiang Med Univ Dept Hematol Affiliated Hosp 1 Urumqi Peoples R China;

    Inner Mongolia Med Univ Dept Hematol Affiliated Hosp Hohhot Peoples R China;

    Fujian Med Univ Fujian Inst Hematol Union Hosp Fuzhou Peoples R China;

    Zhengzhou Univ Dept Hematol Affiliated Canc Hosp Zhengzhou Peoples R China;

    Kunming Med Univ Dept Hematol Affiliated Hosp 2 Kunming Yunnan Peoples R China;

    First Hosp Jilin Univ Dept Hematol Changchun Peoples R China;

    Lanzhou Univ Dept Hematol Hosp 2 Lanzhou Peoples R China;

    Shandong Univ Dept Hematol Shandong Prov Hosp Jinan Peoples R China;

    Tianjin Med Univ Gen Hosp Dept Hematol Tianjin Peoples R China;

    Minist Hlth Dept Hematol Beijing Hosp Beijing Peoples R China;

    Shanxi Med Univ Dept Hematol Affiliated Hosp 2 Taiyuan Peoples R China;

    Shanxi Med Univ Dept Hematol Affiliated Shanxi Big Hosp Taiyuan Peoples R China;

    Guangzhou First Peoples Hosp Dept Hematol Guangzhou Peoples R China;

    Third Mil Med Univ Xinqiao Hosp Chongqing Peoples R China;

    Peking Univ Dept Hematol Hosp 1 Beijing Peoples R China;

    Shanghai Jiao Tong Univ Rui Jin Hosp Sch Med Shanghai Peoples R China;

    Nanfang Med Univ Nanfang Hosp Guangzhou Peoples R China;

    Capital Med Univ Beijing Luhe Hosp Beijing Peoples R China;

    Chinese Acad Med Sci &

    Peking Union Med Coll Peking Union Med Coll Hosp Dept Hematol Beijing;

    Capital Med Univ Fuxing Hosp Beijing Peoples R China;

    Hebei Med Univ Dept Hematol Hosp 2 Shijiazhuang Hebei Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Chinese Acad Sci Collaborat Innovat Ctr Genet &

    Dev Beijing Inst Genom Key Lab Genom &

    Precis;

    Chinese Acad Sci Collaborat Innovat Ctr Genet &

    Dev Beijing Inst Genom Key Lab Genom &

    Precis;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

    Peking Univ Peoples Hosp Inst Hematol Beijing Peoples R China;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 基础医学;
  • 关键词

    Immune thrombocytopenia; intracranial hemorrhage; outcome; risk stratification;

    机译：免疫血小板减少症;颅内出血;结果;风险分层;

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