Outcomes and Associations in Hospitalized Patients with Concomitant Helicobacter Pylori Infection and Idiopathic Thrombocytopenic Purpura(ITP)

Background

Studies have shown that H. pylori infection could be associated with Idiopathic Thrombocytopenic (ITP) in some patients. Multiple studies have also reported improvement and resolution of ITP after H. pylori eradication therapy in these patients. This study explores adverse outcomes in hospitalized patients with ITP and H pylori infection, explicitly focusing on mortality rates and length of stay in affected patients.

Methods

This retrospective cohort study utilized the 2018 to 2020 National Inpatient Sample (NIS) database. The inclusion criteria included adults aged 18 and above diagnosed with idiopathic thrombocytopenic purpura during hospitalization, with or without H pylori infection. We defined ITP and H. pylori infection using ICD-10 codes. We analyzed the demographic data of these patients and their correlation with hospital outcomes, including length of stay, hospitalization costs, and mortality rates. Using univariate and multivariate logistics regression models, we measured mortality as the primary outcome.

Result

We identified 149,780 patients with ITP, among whom 350 (0.2%) had concomitant diagnosis of H. pylori infection. ITP patients were primarily female and white, with a mean age of 61. Patients with concomitant H. pylori infection had a significantly more extended stay of nine vs. seven days, p=0.02. Individuals with H. pylori infection exhibited lower odds of death on univariable and after multivariable regression. However, this fails to meet statistical significance [0.32, 95% CI (0.04-2.30)] and [0.30, 95% CI (0.04-2.16)], likely underpowered by the rarity of co-existing pathology.

Conclusion

Our study shows that the mortality odds among individuals with idiopathic thrombocytopenic purpura were lower in patients with concurrent H. pylori infection than those without H pylori. Though limited by statistical power, it gives credence to previous studies showing that treating co-existing H pylori infections may permanently lead to platelet recovery and possible resolution of their ITP.

No relevant conflicts of interest to declare.