High risk of severe bleeding in aged patients with chronic idiopathic
thrombocytopenic purpura
S Cortelazzo, G Finazzi, M Buelli, A Molteni, P Viero and T Barbui
Divisione di Ematologia, Ospedali Riuniti di Bergamo, Italy.
The purpose of this study was to estimate the incidence and to establish
which factors were associated with an increased risk of hemorrhagic
complications in an historic cohort of 117 consecutive and unselected
patients with chronic idiopathic thrombocytopenic purpura (ITP).
Sixty-eight patients (58%) underwent medical treatment and/or splenectomy
and 33 (48% of treated) achieved a complete stable remission. At equivalent
platelet count the incidence of major hemorrhagic complications was
significantly higher in aged (greater than 60 years) than in younger (less
than 40 years) patients (10.4% v 0.4%/pt-y, relative risk = 28.9, P less
than .01). A previous hemorrhagic event was identified as another major
risk factor for hemorrhage (relative risk = 27.5, P less than .0005), while
hypertension and underlying disorders had no influence. We conclude that
age more than 60 years and a previous history of bleeding are major risk
factors for severe hemorrhages in adults with ITP.
Volume 77,
Issue 1,
pp. 31-33,
01/01/1991
Copyright © 1991 by The American Society of Hematology