Piel-Julian et al identified risk factors for bleeding in adults with newly-diagnosed immune thrombocytopenia. These can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in France.
Patient: newly-diagnosed immune thrombocytopenia
Parameters associated with severe bleeding:
(1) platelet count in 10^9/L
(2) sex
(3) exposure to anticoagulant drug
(4) Charlson Comorbidity Index (CCI)
|
Parameter
|
Finding
|
Points
|
|
platelet count
|
>= 20 * 10^9/L
|
0
|
|
|
< 20 * 10^9/L
|
1 (odds ratio 2.6)
|
|
sex
|
female
|
0
|
|
|
male
|
1 (odds ratio 2.5)
|
|
exposure to anticoagulant drug
|
no
|
0
|
|
|
yes
|
1 (odds ratio 4.3)
|
|
CCI
|
0
|
0
|
|
|
>= 1
|
1 (odds ratio 2.0)
|
Additional factors that may contribute to severe bleeding:
(1) age >= 80 years (odds ratio 1.5)
(2) high blood pressure (odds ratio 1.5)
(3) exposure to NSAIDS (odds ratio 1.7)
(4) exposure to serotonin reuptake inhibitor (SRI; odds ratio 1.5)
Risk factors for any bleeding:
(1) platelet count < 10 * 10^9/L (odds ratio 48); 10-19 * 10^9/L (odds ratio 4.1)
(2) female sex (odds ratio 1.6)
(3) exposure to NSAIDs (odds ratio 4.8)
