Risk factors for skin, mucosal, and organ bleeding in adults with primary ITP: a nationwide study in Japan
| Autor: | Naoki Shimada, Toshiro Takafuta, Takaaki Hato, Yoshiyuki Kurata, Hirokazu Kashiwagi, Mitsuru Murata, Masataka Kuwana, Yoshiaki Tomiyama, Kingo Fujimura |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Hemorrhage 030204 cardiovascular system & hematology Gastroenterology Thrombosis and Hemostasis 03 medical and health sciences 0302 clinical medicine Japan Melena Risk Factors Internal medicine hemic and lymphatic diseases medicine Humans Platelet Risk factor Purpura Thrombocytopenic Idiopathic business.industry Platelet Count Incidence (epidemiology) Mucous membrane Hematology Odds ratio Middle Aged Confidence interval Purpura medicine.anatomical_structure 030220 oncology & carcinogenesis medicine.symptom business |
| Zdroj: | Blood advances. 4(8) |
| ISSN: | 2473-9537 |
| Popis: | Bleeding manifestations in primary immune thrombocytopenia (ITP) range from skin petechiae to life-threatening intracranial hemorrhage (ICH). However, the relation between these various bleeding manifestations and the platelet count in ITP remains poorly characterized. Using a nationwide database of patients with ITP during the years 2005 to 2014 (10 years) in Japan, we analyzed 19 415 adult patients newly diagnosed with ITP, including 222 with ICH. The frequency of skin purpura was 64.8%, and this increased linearly with thrombocytopenia without a specific platelet count threshold. In contrast, mucosal bleeding (epistaxis and gingival bleeding) and organ bleeding (melena, hematuria, and ICH) increased exponentially with thrombocytopenia at a platelet count threshold of 10 to 15 × 109/L. Age showed a much weaker correlation than platelet count with skin and mucosal bleeding. However, the incidence of organ bleeding increased exponentially above 60 years of age. Multivariate analysis showed that the presence of mucosal bleeding was a risk factor for occurrence of melena and hematuria but not for ICH. The frequency of ICH was 1.1% and risk factors for ICH were age ≥60 years (odds ratio [OR], 3.09; 95% confidence interval [CI], 2.13-4.47; P < .001), platelet count |
| Databáze: | OpenAIRE |
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