Characteristics of patients with ITP and critical bleeding at presentation to the ER
| Characteristics . | Adults, n = 15 (%) . | Children, n = 13 (%) . |
|---|---|---|
| Female | 7 (46.7) | 9 (69.2) |
| Age, median (IQR), y | 68 (45-74) | 11 (5-16) |
| Type of bleeds∗ | ||
| ICH | 12 (80.0) | 6 (46.2) |
| Gastrointestinal bleeding | 2 (13.3) | 1 (7.7) |
| Pulmonary bleeding | 1 (6.7) | — |
| Epistaxis | — | 4 (30.8) |
| Gynecological bleeding | — | 3 (23.1) |
| Noncritical concurrent sites of bleeding | ||
| None | 4 (26.7) | 6 (46.2) |
| Skin | 10 (66.7) | 6 (46.2) |
| Oral | 6 (40.0) | 1 (7.7) |
| Gastrointestinal | 5 (33.3) | 2 (15.4) |
| Epistaxis | 3 (20.0) | 0 (0.0) |
| Urinary | 4 (26.7) | 1 (7.7) |
| ITP disease stage | ||
| Newly diagnosed ITP (<3 months) | 8 (53.3) | 6 (46.2) |
| Persistent ITP (3-12 months) | 1 (6.7) | 3 (23.1) |
| Chronic ITP (>12 months) | 5 (33.3) | 3 (23.1) |
| Unknown | 1 (6.7) | 1 (7.7) |
| Race | ||
| Black/African/Afro-Caribbean | 3 (20.0) | 2 (15.4) |
| White | 2 (13.3) | 5 (38.5) |
| Unknown | 10 (66.7) | 6 (46.2) |
| Comorbidities† | 10 (66.7) | 2 (15.4) |
| Lowest platelets count during visit, median (IQR), ×109/L | 8 (3-15) | 3 (1-6) (n = 11) |
| Lowest hemoglobin during visit, median (IQR), g/L | 77 (63-106) | 79.5 (69-100) (n = 10) |
| No. of distinct ITP treatments previously received, median (IQR) | 3 (1.5-5) (n = 7) | 3 (2-5) (n = 9) |
| Previous use of TPO-RAs | 3 (20.0) | 4 (30.8) |
| History of splenectomy | 4 (26.7) | 1 (7.7) |
| Timing of critical bleed | ||
| Prevalent (on ER arrival or before) | 10 (66.7) | 12 (92.3) |
| Incident (day 2 onward) | 5 (33.3) | 1 (7.7) |
| Time from ER arrival to imaging for ICH patients, median (IQR), h | 11.5 (3-28.5) (n = 12) | 2.5 (0-5) (n = 6) |
| Critical bleed as initial presentation of ITP | 8 (53.3) | 4 (30.8) |
| Duration of ITP, median (IQR), mo | 78.5 (49-151.5) (n = 6 [40.0%]) | 10 (1-14) (n = 9 [69.2%]) |
| Subsequent critical bleed at a later visit | 1 (6.7) | 0 (0.0) |
| Characteristics . | Adults, n = 15 (%) . | Children, n = 13 (%) . |
|---|---|---|
| Female | 7 (46.7) | 9 (69.2) |
| Age, median (IQR), y | 68 (45-74) | 11 (5-16) |
| Type of bleeds∗ | ||
| ICH | 12 (80.0) | 6 (46.2) |
| Gastrointestinal bleeding | 2 (13.3) | 1 (7.7) |
| Pulmonary bleeding | 1 (6.7) | — |
| Epistaxis | — | 4 (30.8) |
| Gynecological bleeding | — | 3 (23.1) |
| Noncritical concurrent sites of bleeding | ||
| None | 4 (26.7) | 6 (46.2) |
| Skin | 10 (66.7) | 6 (46.2) |
| Oral | 6 (40.0) | 1 (7.7) |
| Gastrointestinal | 5 (33.3) | 2 (15.4) |
| Epistaxis | 3 (20.0) | 0 (0.0) |
| Urinary | 4 (26.7) | 1 (7.7) |
| ITP disease stage | ||
| Newly diagnosed ITP (<3 months) | 8 (53.3) | 6 (46.2) |
| Persistent ITP (3-12 months) | 1 (6.7) | 3 (23.1) |
| Chronic ITP (>12 months) | 5 (33.3) | 3 (23.1) |
| Unknown | 1 (6.7) | 1 (7.7) |
| Race | ||
| Black/African/Afro-Caribbean | 3 (20.0) | 2 (15.4) |
| White | 2 (13.3) | 5 (38.5) |
| Unknown | 10 (66.7) | 6 (46.2) |
| Comorbidities† | 10 (66.7) | 2 (15.4) |
| Lowest platelets count during visit, median (IQR), ×109/L | 8 (3-15) | 3 (1-6) (n = 11) |
| Lowest hemoglobin during visit, median (IQR), g/L | 77 (63-106) | 79.5 (69-100) (n = 10) |
| No. of distinct ITP treatments previously received, median (IQR) | 3 (1.5-5) (n = 7) | 3 (2-5) (n = 9) |
| Previous use of TPO-RAs | 3 (20.0) | 4 (30.8) |
| History of splenectomy | 4 (26.7) | 1 (7.7) |
| Timing of critical bleed | ||
| Prevalent (on ER arrival or before) | 10 (66.7) | 12 (92.3) |
| Incident (day 2 onward) | 5 (33.3) | 1 (7.7) |
| Time from ER arrival to imaging for ICH patients, median (IQR), h | 11.5 (3-28.5) (n = 12) | 2.5 (0-5) (n = 6) |
| Critical bleed as initial presentation of ITP | 8 (53.3) | 4 (30.8) |
| Duration of ITP, median (IQR), mo | 78.5 (49-151.5) (n = 6 [40.0%]) | 10 (1-14) (n = 9 [69.2%]) |
| Subsequent critical bleed at a later visit | 1 (6.7) | 0 (0.0) |
In adults: ICH (n = 9), ICH with respiratory compromise (n = 2), ICH with hemodynamic instability and respiratory compromise (n = 1), gastrointestinal bleeding with hemodynamic instability (n = 2), and pulmonary bleeding with respiratory compromise (n = 1). In children: ICH (n = 3), ICH with hemodynamic instability and respiratory compromise (n = 2), ICH with hemodynamic instability (n = 1), gastrointestinal bleeding with respiratory compromise (n = 1), epistaxis with hemodynamic instability (n = 3), and epistaxis with hemodynamic instability and respiratory compromise (n = 1).
In adults: comorbidities included myocardial infarction (n = 2), congestive heart failure (n = 5), peripheral vascular disease (n = 1), cerebral vascular accident or transient ischemic attack (n = 5), chronic obstructive pulmonary disease (n = 2), liver disease (n = 1), diabetes (n = 3), moderate to severe chronic kidney disease (n = 2), solid tumor (n = 1), leukemia (n = 1), lymphoma (n = 1), autoimmune hemolytic anemia (n = 2), and rheumatoid arthritis (n = 1). In children: comorbidities included diabetes (n = 1) and autoimmune hemolytic anemia (n = 1).