Epistaxis duration predicts bleeding in immune thrombocytopenia : a cohort study
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVE: To test for an association between duration of epistaxis and clinically relevant bleeding in the following 12 months in children with immune thrombocytopenia (ITP).
DESIGN: Prospective cohort study.
SETTING: The national UK Paediatric ITP registry, a multicentre prospective clinical registry of new cases of ITP between 2006 and February 2020.
PATIENTS: All children aged between 2 months and 16 years in participating UK centres.
EXPOSURE: Epistaxis at presentation defined as none, <10 min, 10-30 min and >30 min.
MAIN OUTCOME MEASURES: Incident severe bleeds, combined moderate and severe bleeds and drop in haemoglobin (Hb) by ≥20 g/L.
RESULTS: The sample included 1793 patients, of which 334 had epistaxis <10 min, 88 lasting 10-30 min and 97 >30 min. In the 12 months following presentation, 19 had a severe bleed, 140 had a moderate bleed and 54 had a drop in Hb ≥2 g/dL. Epistaxis >30 min duration was associated with increased odds of severe bleeds (OR 1.43-15.67), moderate or severe bleeding (OR 1.33-4.2) and drop in Hb (OR 1.23-6.91). Shorter duration epistaxis was not associated with increased odds of any outcome. A trend for increased odds with longer duration epistaxis was significant for all outcomes.
CONCLUSIONS: The longer the duration of epistaxis at presentation with ITP, the higher the risk of a clinically significant bleeding event in the 12 months following. This should inform clinical severity ratings and treatment decisions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:107 |
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| Enthalten in: |
Archives of disease in childhood - 107(2022), 12 vom: 17. Dez., Seite 1117-1121 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Reynolds, Lianna [VerfasserIn] |
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| Links: |
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| Themen: |
Child Health |
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| Anmerkungen: |
Date Completed 21.11.2022 Date Revised 12.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/archdischild-2021-323064 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM349094535 |
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| 500 | |a Date Revised 12.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVE: To test for an association between duration of epistaxis and clinically relevant bleeding in the following 12 months in children with immune thrombocytopenia (ITP) | ||
| 520 | |a DESIGN: Prospective cohort study | ||
| 520 | |a SETTING: The national UK Paediatric ITP registry, a multicentre prospective clinical registry of new cases of ITP between 2006 and February 2020 | ||
| 520 | |a PATIENTS: All children aged between 2 months and 16 years in participating UK centres | ||
| 520 | |a EXPOSURE: Epistaxis at presentation defined as none, <10 min, 10-30 min and >30 min | ||
| 520 | |a MAIN OUTCOME MEASURES: Incident severe bleeds, combined moderate and severe bleeds and drop in haemoglobin (Hb) by ≥20 g/L | ||
| 520 | |a RESULTS: The sample included 1793 patients, of which 334 had epistaxis <10 min, 88 lasting 10-30 min and 97 >30 min. In the 12 months following presentation, 19 had a severe bleed, 140 had a moderate bleed and 54 had a drop in Hb ≥2 g/dL. Epistaxis >30 min duration was associated with increased odds of severe bleeds (OR 1.43-15.67), moderate or severe bleeding (OR 1.33-4.2) and drop in Hb (OR 1.23-6.91). Shorter duration epistaxis was not associated with increased odds of any outcome. A trend for increased odds with longer duration epistaxis was significant for all outcomes | ||
| 520 | |a CONCLUSIONS: The longer the duration of epistaxis at presentation with ITP, the higher the risk of a clinically significant bleeding event in the 12 months following. This should inform clinical severity ratings and treatment decisions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a Grainger, John |e verfasserin |4 aut | |
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