原文信息:
Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality Blood. 2015 Jan 14. pii: blood-2014-10-605493. 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). Age and gender-adjusted odds ratios (AdjOR) associated with platelet transfusions were calculated. There were 10,624 hospitalizations with TTP; 6,332 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. These data suggest that platelet transfusions are associated with higher odds of arterial thrombosis and mortality among TTP and HIT patients.
原文链接:http://www.bloodjournal.org/content/early/2015/01/21/blood-2014-10-605493.long?sso-checked=true |