Risk stratification and outcomes of intracranial hemorrhage in patients with immune thrombocytopenia under 60 years of age
Peng Zhao, Ming Hou, Yi Liu, Huixin Liu, Ruibin Huang, Hongxia Yao, Ting Niu, Jun Peng, Ming Jiang, Yanqiu Han, Jianda Hu, Hu Zhou, Zeping Zhou, Lin Qiu, Liansheng Zhang, Xin Wang, Huaquan Wang, Ru Feng, Linhua Yang, Liangming Ma, Shunqing Wang, Peiyan Kong, Wensheng Wang, Huiping Sun, Jing Sun, Hebing Zhou, Tienan Zhu, Liru Wang, Jingyu Zhang, Qiu-Sha Huang, Xiao Liu, Hai‐Xia Fu, Yueying Li, Qian‐Fei Wang, Qian Jiang, Hao Jiang, Jin Lu, Xiaohui Zhang
Abstract
Intracranial hemorrhage (ICH) is a devastating complication of immune thrombocytopenia (ITP). However, information on ICH in ITP patients under the age of 60 years is limited, and no predictive tools are available in clinical practice. A total of 93 adult patients with ITP who developed ICH before 60 years of age were retrospectively identified from 2005 to 2019 by 27 centers in China. For each case, 2 controls matched by the time of ITP diagnosis and the duration of ITP were provided by the same center. Multivariate analysis identified head trauma (OR = 3.216, 95%CI 1.296–7.979, P =.012), a platelet count ≤ 15,000/μL at the time of ITP diagnosis (OR = 1.679, 95%CI 1.044–2.698, P =.032) and severe/life-threatening bleeding (severe bleeding vs. mild bleeding, OR = 1.910, 95%CI 1.088–3.353, P =.024; life-threatening bleeding vs. mild bleeding, OR = 2.620, 95%CI 1.360–5.051, P =.004) as independent risk factors for ICH. Intraparenchymal hemorrhage (OR = 5.191, 95%CI 1.717–15.692, P =.004) and a history of severe bleeding (OR = 4.322, 95%CI 1.532–12.198, P =.006) were associated with the 30-day outcome of ICH. These findings may facilitate ICH risk stratification and outcome prediction in patients with ITP.