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Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study

Intracranial hemorrhage (ICH) is a rare and life-threatening hemorrhagic event in patients with immune thrombocytopenia (ITP). However, its mortality and related risk factors remain unclear. Herein, we conducted a nationwide multicenter real-world study of ICH in adult ITP patients. According to dat...

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Autores principales: Chong, Shan, Zhao, Peng, Huang, Rui-Bin, Zhou, Hu, Zhang, Jia-Ning, Hou, Ming, Liu, Yi, Yao, Hong-Xia, Niu, Ting, Peng, Jun, Jiang, Ming, Han, Yan-Qiu, Hu, Jian-Da, Zhou, Ze-Ping, Qiu, Lin, Zhang, Lian-Sheng, Wang, Xin, Wang, Hua-Quan, Feng, Ru, Yang, Lin-Hua, Ma, Liang-Ming, Wang, Shun-Qing, Kong, Pei-Yan, Wang, Wen-Sheng, Sun, Hui-Ping, Sun, Jing, Zhou, He-Bing, Zhu, Tie-Nan, Wang, Li-Ru, Zhang, Jing-Yu, Huang, Qiu-Sha, Fu, Hai-Xia, Wu, Ye-Jun, Li, Yue-Ying, Wang, Qian-Fei, Jiang, Qian, Jiang, Hao, Lu, Jin, Huang, Xiao-Jun, Zhang, Xiao-Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Hematology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9327537/
https://www.ncbi.nlm.nih.gov/pubmed/35679462
http://dx.doi.org/10.1182/bloodadvances.2022007226
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author Chong, Shan
Zhao, Peng
Huang, Rui-Bin
Zhou, Hu
Zhang, Jia-Ning
Hou, Ming
Liu, Yi
Yao, Hong-Xia
Niu, Ting
Peng, Jun
Jiang, Ming
Han, Yan-Qiu
Hu, Jian-Da
Zhou, Ze-Ping
Qiu, Lin
Zhang, Lian-Sheng
Wang, Xin
Wang, Hua-Quan
Feng, Ru
Yang, Lin-Hua
Ma, Liang-Ming
Wang, Shun-Qing
Kong, Pei-Yan
Wang, Wen-Sheng
Sun, Hui-Ping
Sun, Jing
Zhou, He-Bing
Zhu, Tie-Nan
Wang, Li-Ru
Zhang, Jing-Yu
Huang, Qiu-Sha
Fu, Hai-Xia
Wu, Ye-Jun
Li, Yue-Ying
Wang, Qian-Fei
Jiang, Qian
Jiang, Hao
Lu, Jin
Huang, Xiao-Jun
Zhang, Xiao-Hui
author_facet Chong, Shan
Zhao, Peng
Huang, Rui-Bin
Zhou, Hu
Zhang, Jia-Ning
Hou, Ming
Liu, Yi
Yao, Hong-Xia
Niu, Ting
Peng, Jun
Jiang, Ming
Han, Yan-Qiu
Hu, Jian-Da
Zhou, Ze-Ping
Qiu, Lin
Zhang, Lian-Sheng
Wang, Xin
Wang, Hua-Quan
Feng, Ru
Yang, Lin-Hua
Ma, Liang-Ming
Wang, Shun-Qing
Kong, Pei-Yan
Wang, Wen-Sheng
Sun, Hui-Ping
Sun, Jing
Zhou, He-Bing
Zhu, Tie-Nan
Wang, Li-Ru
Zhang, Jing-Yu
Huang, Qiu-Sha
Fu, Hai-Xia
Wu, Ye-Jun
Li, Yue-Ying
Wang, Qian-Fei
Jiang, Qian
Jiang, Hao
Lu, Jin
Huang, Xiao-Jun
Zhang, Xiao-Hui
author_sort Chong, Shan
collection PubMed
description Intracranial hemorrhage (ICH) is a rare and life-threatening hemorrhagic event in patients with immune thrombocytopenia (ITP). However, its mortality and related risk factors remain unclear. Herein, we conducted a nationwide multicenter real-world study of ICH in adult ITP patients. According to data from 27 centers in China from 2005 to 2020, the mortality rate from ICH was 33.80% (48/142) in ITP adults. We identified risk factors by logistic univariate and multivariate logistic regression for 30-day mortality in a training cohort of 107 patients as follows: intraparenchymal hemorrhage (IPH), platelet count ≤10 × 10(9)/L at ICH, a combination of serious infections, grade of preceding bleeding events, and Glasgow coma scale (GCS) level on admission. Accordingly, a prognostic model of 30-day mortality was developed based on the regression equation. Then, we evaluated the performance of the prognostic model through a bootstrap procedure for internal validation. Furthermore, an external validation with data from a test cohort with 35 patients from 11 other centers was conducted. The areas under the receiver operating characteristic (ROC) curves for the internal and external validation were 0.954 (95% confidence interval [CI], 0.910-0.998) and 0.942 (95% CI, 0.871-1.014), respectively. Both calibration plots illustrated a high degree of consistency in the estimated and observed risk. In addition, the decision curve analysis showed a considerable net benefit for patients. Thus, an application (47.94.162.105:8080/ich/) was established for users to predict 30-day mortality when ICH occurred in adult patients with ITP.
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spelling pubmed-93275372022-08-01 Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study Chong, Shan Zhao, Peng Huang, Rui-Bin Zhou, Hu Zhang, Jia-Ning Hou, Ming Liu, Yi Yao, Hong-Xia Niu, Ting Peng, Jun Jiang, Ming Han, Yan-Qiu Hu, Jian-Da Zhou, Ze-Ping Qiu, Lin Zhang, Lian-Sheng Wang, Xin Wang, Hua-Quan Feng, Ru Yang, Lin-Hua Ma, Liang-Ming Wang, Shun-Qing Kong, Pei-Yan Wang, Wen-Sheng Sun, Hui-Ping Sun, Jing Zhou, He-Bing Zhu, Tie-Nan Wang, Li-Ru Zhang, Jing-Yu Huang, Qiu-Sha Fu, Hai-Xia Wu, Ye-Jun Li, Yue-Ying Wang, Qian-Fei Jiang, Qian Jiang, Hao Lu, Jin Huang, Xiao-Jun Zhang, Xiao-Hui Blood Adv Thrombosis and Hemostasis Intracranial hemorrhage (ICH) is a rare and life-threatening hemorrhagic event in patients with immune thrombocytopenia (ITP). However, its mortality and related risk factors remain unclear. Herein, we conducted a nationwide multicenter real-world study of ICH in adult ITP patients. According to data from 27 centers in China from 2005 to 2020, the mortality rate from ICH was 33.80% (48/142) in ITP adults. We identified risk factors by logistic univariate and multivariate logistic regression for 30-day mortality in a training cohort of 107 patients as follows: intraparenchymal hemorrhage (IPH), platelet count ≤10 × 10(9)/L at ICH, a combination of serious infections, grade of preceding bleeding events, and Glasgow coma scale (GCS) level on admission. Accordingly, a prognostic model of 30-day mortality was developed based on the regression equation. Then, we evaluated the performance of the prognostic model through a bootstrap procedure for internal validation. Furthermore, an external validation with data from a test cohort with 35 patients from 11 other centers was conducted. The areas under the receiver operating characteristic (ROC) curves for the internal and external validation were 0.954 (95% confidence interval [CI], 0.910-0.998) and 0.942 (95% CI, 0.871-1.014), respectively. Both calibration plots illustrated a high degree of consistency in the estimated and observed risk. In addition, the decision curve analysis showed a considerable net benefit for patients. Thus, an application (47.94.162.105:8080/ich/) was established for users to predict 30-day mortality when ICH occurred in adult patients with ITP. American Society of Hematology 2022-07-25 /pmc/articles/PMC9327537/ /pubmed/35679462 http://dx.doi.org/10.1182/bloodadvances.2022007226 Text en © 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.
spellingShingle Thrombosis and Hemostasis
Chong, Shan
Zhao, Peng
Huang, Rui-Bin
Zhou, Hu
Zhang, Jia-Ning
Hou, Ming
Liu, Yi
Yao, Hong-Xia
Niu, Ting
Peng, Jun
Jiang, Ming
Han, Yan-Qiu
Hu, Jian-Da
Zhou, Ze-Ping
Qiu, Lin
Zhang, Lian-Sheng
Wang, Xin
Wang, Hua-Quan
Feng, Ru
Yang, Lin-Hua
Ma, Liang-Ming
Wang, Shun-Qing
Kong, Pei-Yan
Wang, Wen-Sheng
Sun, Hui-Ping
Sun, Jing
Zhou, He-Bing
Zhu, Tie-Nan
Wang, Li-Ru
Zhang, Jing-Yu
Huang, Qiu-Sha
Fu, Hai-Xia
Wu, Ye-Jun
Li, Yue-Ying
Wang, Qian-Fei
Jiang, Qian
Jiang, Hao
Lu, Jin
Huang, Xiao-Jun
Zhang, Xiao-Hui
Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title_full Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title_fullStr Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title_full_unstemmed Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title_short Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study
title_sort developing and validating a mortality prediction model for ich in itp: a nationwide representative multicenter study
topic Thrombosis and Hemostasis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9327537/
https://www.ncbi.nlm.nih.gov/pubmed/35679462
http://dx.doi.org/10.1182/bloodadvances.2022007226
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