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

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

来源：Platelets, 2021, 32(5): 633-641.

DOI：10.1080/09537104.2020.1786042

• Immune thrombocytopenia
• intracranial hemorrhage
• outcome
• risk stratification

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.

• 单位
  中国医学科学院; 1; 北京大学; 南方医科大学; 河北医科大学; 南昌大学; 山东大学; 上海交通大学; 郑州大学; 中国科学院; 四川大学; 内蒙古医学院; 中国医学科学院北京协和医院; 吉林大学; 兰州大学