Presentation Details
| Outcomes and Predictors of Immune Thrombocytopenia in Hospitalizations for Antiphospholipid Syndrome: A Nationwide Inpatient Sample Analysis Michael Imeh1, Ani Gvajaia1, Chukwunonye Amaeshi2, Fidelis Uwumiro3. 1Lincoln Medical and Mental Health Centre, Bronx, NY, USA.2Montefiore Medical Centre, Bronx, NY, USA.3University of Benin Teaching Hospital, Benin, Nigeria |
Abstract
Background/Objectives: Immune thrombocytopenia (ITP) is reported to complicate up to 50% of hospitalizations for antiphospholipid syndrome (APS). We evaluated the impact of ITP on outcomes of APS hospitalization using nationwide data. In addition, we identified factors associated with an increased likelihood of ITP. Methods: We queried the 2016–2020 nationwide inpatient sample database for adult APS hospitalizations using the relevant International Classification of Diseases, 10th revision codes. Pearson’s χ2 analysis or Fisher exact tests were used to evaluate categorical variables; alternatively, continuous variables were analyzed using the t-test and Wilcoxon rank sum test for normally and non-normally distributed data, respectively. Predictors of ITP and the impact of ITP on mortality and odds of thrombosis were assessed using stepwise multivariable regression analysis, whereas its impact on duration of hospitalization and cost of care was evaluated using linear regression analysis. Illness severity, baseline risk of mortality, and comorbidity burden were adjusted using all patient refined-diagnosis-related groups (APR-DRG) metrics and the Charlson comorbidity index (CCI). Results: The study analyzed 1,710 hospitalizations for APS, of which 345 (25.3%) cases of ITP were recorded. Most patients who developed ITP were female (56.5%) and white (69.7%), with a mean age of 44.5 years (SD, 2 years). APS with ITP was associated with a greater comorbidity burden compared with APS alone (CCI ≥2: 68.1% vs. 53%; P=0.026). A total of 149 mortalities were recorded in the study. ITP was correlated with greater odds of mortality (aOR: 1.12; 95% CI: 1.02-2.41; P=0.005), higher cost of care (mean: $108 441 vs. $136 345; P=0.033), and greater odds of venous thrombosis (aOR: 1.27; 95% CI: 1.08-2.28; P=0.042). Co-existing SLE (aOR: 3.19; 95% CI: 2.00-4.51; P=0.002) and age between 18 and 40 years (aOR: 1.97; 95% CI: 1.11-3.01; P=0.001) were correlated with greater odds of ITP in the study. Conclusion: APS with ITP was correlated with poorer outcomes, including mortality, venous thrombosis, and higher mean hospital costs compared with APS hospitalizations without ITP.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
Content Locked. Log into a registered attendee account to access this presentation.