Abstract | BACKGROUND: METHODS: RESULTS: Among the 4032 patients (mean age 47.5 years, 67.7% women, and 36.9% white) with thrombotic thrombocytopenic purpura who also underwent plasmapheresis, in-hospital mortality was 11.1%. Independent predictors of increased in-hospital mortality were older age (odds ratio [OR] 1.03; 95% confidence interval [CI], 1.02-1.04; P <.001), acute myocardial infarction (OR 1.89; 95% CI, 1.24-2.88; P = .003), acute renal failure (OR 2.75; 95% CI, 2.11-3.58; P <.001), congestive heart failure (OR 1.66; 95% CI, 1.17-2.34; P = .004), acute cerebrovascular disease (OR 2.68; 95% CI, 1.87-3.85; P <.001), cancer (OR 2.49; 95% CI, 1.83-3.40; P <.001), and sepsis (OR 2.59; 95% CI, 1.88-3.59; P <.001). Independent predictors of acute myocardial infarction were older age (OR 1.03; 95% CI, 1.02-1.04; P <.001), smoking (OR 1.60; 95% CI, 1.14-2.24; P = .007), known coronary artery disease (OR 2.59; 95% CI, 1.76-3.81; P <.001), and congestive heart failure (OR 2.40; 95% CI, 1.71-3.37; P <.001). CONCLUSION: In this large national database, patients with thrombotic thrombocytopenic purpura had an in-hospital mortality rate of 11.1% and an acute myocardial infarction rate of 5.7%. Predictors of in-hospital mortality were older age, acute myocardial infarction, acute renal failure, congestive heart failure, acute cerebrovascular disease, cancer, and sepsis. Predictors of acute myocardial infarction were older age, smoking, known coronary artery disease, and congestive heart failure.
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Authors | Nivas Balasubramaniyam, Dhaval Kolte, Chandrasekar Palaniswamy, Kiran Yalamanchili, Wilbert S Aronow, John A McClung, Sahil Khera, Sachin Sule, Stephen J Peterson, William H Frishman |
Journal | The American journal of medicine
(Am J Med)
Vol. 126
Issue 11
Pg. 1016.e1-7
(Nov 2013)
ISSN: 1555-7162 [Electronic] United States |
PMID | 23993262
(Publication Type: Journal Article)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Databases, Factual
- Female
- Hospital Mortality
- Hospitalization
- Humans
- Incidence
- Kaplan-Meier Estimate
- Logistic Models
- Male
- Middle Aged
- Myocardial Infarction
(epidemiology, etiology, mortality)
- Plasmapheresis
- Prognosis
- Purpura, Thrombotic Thrombocytopenic
(complications, mortality, therapy)
- Retrospective Studies
- Risk Factors
- Young Adult
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