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Predictors of In-Hospital Mortality in Thrombotic Thrombocytopenic Purpura in Children in the United States: A Population Analysis.
Umapathi, Krishna Kishore; Thavamani, Aravind; Puliyel, Mammen.
Afiliação
  • Umapathi KK; Departments of Pediatrics.
  • Thavamani A; Departments of Pediatrics.
  • Puliyel M; Pediatric Hematology, Metro Health Medical Center, Case Western Reserve University, Cleveland, OH.
J Pediatr Hematol Oncol ; 42(5): e340-e344, 2020 07.
Article em En | MEDLINE | ID: mdl-32011563
ABSTRACT

BACKGROUND:

Despite proven efficacy and increased availability of therapeutic plasma exchange, thrombotic thrombocytopenic purpura (TTP) is associated with significant morbidity and mortality. STUDY DESIGN AND

METHODS:

This study utilized the Kids' Inpatient Database and National Inpatient Sample (2003 to 2016) to study predictors of in-hospital mortality in hospitalized TTP patients. Adjusted odds ratios of death with various putative risk factors were calculated using multiple regression analysis.

RESULTS:

Among 1568 hospitalizations with TTP as primary admission diagnosis who underwent therapeutic plasma exchange, 69 deaths were identified (all-cause mortality, 0.04%; median time-to-death, 6 wk). Overall, hospitalizations rates were fairly similar across the study period. The overall incidence of TTP related hospitalizations is 1.51 per 100,000 hospitalizations. A total of 69 deaths were reported with an all-cause in-hospital mortality rate of 0.04% (69/1568). The median time-to-death was 6 weeks. The majority of deaths occurred in age 16 to 20 years (58%), females (56.5%), and African American (42.9%) as shown in Table 2. Mean age for nonsurvivors was 14 years and the mean age of 15 years for survivors (P=0.01). Younger age, male sex, African-American ethnicity, malignancy, sepsis, acute kidney injury, platelet transfusion was significantly associated with mortality in patients with TTP.

CONCLUSIONS:

Early and targeted therapy for high risk individuals should be used to guide management of TTP patients for improved survival outcomes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Troca Plasmática / Púrpura Trombocitopênica Trombótica / Mortalidade Hospitalar / Transfusão de Plaquetas / Hospitalização Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Hematol Oncol Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Troca Plasmática / Púrpura Trombocitopênica Trombótica / Mortalidade Hospitalar / Transfusão de Plaquetas / Hospitalização Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Hematol Oncol Ano de publicação: 2020 Tipo de documento: Article