Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality

Ruchika Goel, Paul Michael Ness, Clifford M Takemoto, Lakshmanan Krishnamurti, Karen Eileen King, Aaron A Tobian

Research output: Contribution to journalArticle

Abstract

While platelets are primary mediators of hemostasis, there is emerging evidence to show that they may also mediate pathologic thrombogenesis. Little data are available on risks and benefits associated with platelet transfusions in thrombotic thrombocytopenic purpura (TTP), heparin-induced thrombocytopenia (HIT) and immune thrombocytopenic purpura (ITP). This study utilized the Nationwide Inpatient Sample to evaluate the current in-hospital platelet transfusion practices and their association with arterial/venous thrombosis, acute myocardial infarction (AMI), stroke, and in-hospital mortality over 5 years (2007-2011).Ageandgender-adjustedoddsratios (adjOR) associated with platelet transfusions were calculated. There were 10 624 hospitalizations with TTP; 6332 with HIT and 79 980 with ITP. Platelet transfusions were reported in 10.1% TTP, 7.1% HIT, and 25.8% ITP admissions. Platelet transfusions in TTP were associated with higher odds of arterial thrombosis (adjOR = 5.8, 95%CI = 1.3-26.6), AMI (adjOR = 2.0, 95%CI = 1.2-3.3) and mortality (adjOR = 2.0,95%CI = 1.3-3.0), but not venous thrombosis. Platelet transfusions in HIT were associated with higher odds of arterial thrombosis (adjOR = 3.4, 95%CI = 1.2-9.5) and mortality (adjOR = 5.2, 95%CI = 2.6-10.5) but not venous thrombosis. Except for AMI, all relationships remained significant after adjusting for clinical severity and acuity. No associations were significant for ITP. Platelet transfusions are associated with higher odds of arterial thrombosis and mortality among TTP and HIT patients.

Original languageEnglish (US)
Pages (from-to)1470-1476
Number of pages7
JournalBlood
Volume125
Issue number9
DOIs
StatePublished - Feb 26 2015

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Platelet Transfusion
Platelets
Hospital Mortality
Thrombotic Thrombocytopenic Purpura
Thrombosis
Blood Platelets
Idiopathic Thrombocytopenic Purpura
Thrombocytopenia
Heparin
Venous Thrombosis
Myocardial Infarction
Mortality
Hemostasis
Inpatients
Hospitalization
Stroke

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology
  • Medicine(all)

Cite this

Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality. / Goel, Ruchika; Ness, Paul Michael; Takemoto, Clifford M; Krishnamurti, Lakshmanan; King, Karen Eileen; Tobian, Aaron A.

In: Blood, Vol. 125, No. 9, 26.02.2015, p. 1470-1476.

Research output: Contribution to journalArticle

Goel, Ruchika ; Ness, Paul Michael ; Takemoto, Clifford M ; Krishnamurti, Lakshmanan ; King, Karen Eileen ; Tobian, Aaron A. / Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality. In: Blood. 2015 ; Vol. 125, No. 9. pp. 1470-1476.
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abstract = "While platelets are primary mediators of hemostasis, there is emerging evidence to show that they may also mediate pathologic thrombogenesis. Little data are available on risks and benefits associated with platelet transfusions in thrombotic thrombocytopenic purpura (TTP), heparin-induced thrombocytopenia (HIT) and immune thrombocytopenic purpura (ITP). This study utilized the Nationwide Inpatient Sample to evaluate the current in-hospital platelet transfusion practices and their association with arterial/venous thrombosis, acute myocardial infarction (AMI), stroke, and in-hospital mortality over 5 years (2007-2011).Ageandgender-adjustedoddsratios (adjOR) associated with platelet transfusions were calculated. There were 10 624 hospitalizations with TTP; 6332 with HIT and 79 980 with ITP. Platelet transfusions were reported in 10.1{\%} TTP, 7.1{\%} HIT, and 25.8{\%} ITP admissions. Platelet transfusions in TTP were associated with higher odds of arterial thrombosis (adjOR = 5.8, 95{\%}CI = 1.3-26.6), AMI (adjOR = 2.0, 95{\%}CI = 1.2-3.3) and mortality (adjOR = 2.0,95{\%}CI = 1.3-3.0), but not venous thrombosis. Platelet transfusions in HIT were associated with higher odds of arterial thrombosis (adjOR = 3.4, 95{\%}CI = 1.2-9.5) and mortality (adjOR = 5.2, 95{\%}CI = 2.6-10.5) but not venous thrombosis. Except for AMI, all relationships remained significant after adjusting for clinical severity and acuity. No associations were significant for ITP. Platelet transfusions are associated with higher odds of arterial thrombosis and mortality among TTP and HIT patients.",
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