ITP: How Do Complications Affect Hospitalization and Mortality?

Among patients with immune thrombocytopenia (ITP), complications and treatment often take a significant toll on hospital length-of-stay (LOS) and mortality, according to new findings presented at the American Society of Hematology Annual Meeting.

Researchers arrived at this conclusion following a retrospective cohort analysis of patients aged 18 years or older with a primary or secondary diagnosis of ITP. Data were obtained from the National Inpatient Sample 2014 Database.

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Among 11,535 patients assessed, epistaxis, gastrointestinal bleeding, intracranial hemorrhage, and septicemia occurred in 15.3%, 3.12%, 0.41%, and 0.99%. Patients with gastrointestinal bleeding (odds ratio [OR] 227) and intracranial hemorrhage (OR 100.88) had a significantly elevated mortality risk.

Mean LOS was 4.73 days, and was highest among patients with septicemia (12.3 days), GIB (8.98 days) ICH (7.99 days), and epistaxis and coagulation disorders (6 days). However, LOS was found to be lower among patients who had undergone splenectomy (AMD -10.67).

Lower LOS was also associated with lack of insurance (AMD -6.60), Medicaid (AMD -3.57), and private insurance (AMD -2.67) compared with Medicare.

However, it was not clear whether the association of insurance status with LOS was related to differences in biological factors—such as age, comorbidities, and frailty—or process factors—such as care management practices and payment incentives.

—Christina Vogt

Reference:

Rai MP, Singh Bedi P, Kaner JD, et al. Immune thrombocytopenia complications: Implications on length of stay and mortality. Paper presented at: 60th American Society of Hematology Annual Meeting & Exposition; December 1-4, 2018; San Diego, CA.