Outcomes of therapeutic plasma exchange in severe autoimmune hemolytic anemia hospitalizations: An analysis of the National Inpatient Sample.

Autor: Abdelhay A; Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA., Mahmoud AA; Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA., Ammari O; Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA., Dalbah R; Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA., Reghis M; Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA., Hashem A; Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA., Alkasem M; School of Medicine, University of Jordan, Amman, Jordan., Mostafa M; Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2023 Jul; Vol. 63 (7), pp. 1376-1383. Date of Electronic Publication: 2023 Jul 03.
DOI: 10.1111/trf.17445
Abstrakt: Background: Autoimmune hemolytic anemia (AIHA) is characterized by humoral and/or cellular immune-mediated hemolysis of red blood cells. The role of therapeutic plasma exchange (TPE) in AIHA is unclear.
Study Design and Methods: We queried the National Inpatient Sample (NIS) for 2002-2019 to identify hospitalizations with the primary diagnosis of AIHA. We included hospitalizations with the highest severity subclass identified by All Patient Refined Disease Related Group (APR-DRG). We used multivariate regression analysis to compare in-hospital mortality and other relevant in-hospital outcomes between hospitalizations that received TPE and those that did not.
Results: We identified 255 weighted hospitalizations in the TPE group and 4973 in the control group. Those in the control group were older (median age 67 vs. 48 years, p < .001) and had a higher prevalence of most comorbidities. The TPE group had higher odds of all-cause in-hospital mortality (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19-2.11). They also had higher rates of many secondary outcomes, including requiring mechanical ventilation, developing circulatory shock, acute stroke, urinary tract infections, intracranial hemorrhage, acute kidney injury, and requiring new hemodialysis. No significant differences were noted in the rates of acute myocardial infarctions, bacterial pneumonia, sepsis/septicemia, thromboembolic events, and other bleeding events. Furthermore, the TPE group had a higher median length of hospital stay (19 vs. 9 days, p < .001).
Conclusion: Hospitalizations with severe AIHA that received TPE had higher rates of adverse in-hospital outcomes.
(© 2023 AABB.)
Databáze: MEDLINE
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