What Factors Raise Splenectomy Risk in Immune Thrombocytopenia?

Rates of splenectomy have declined over time in pediatric patients with immune thrombocytopenia (ITP), according to a recent study.

In order to study the trends of splenectomy in pediatric hospitalizations with ITP, researchers used data from 37,844 ITP hospitalizations from 2005 to 2014. Overall, 954 splenectomies were performed.
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The researchers observed that the rate of splenectomy declined over time (3.4% from 2005 to 2006 to 1.6% from 2013 to 2014). The decline was most notable among younger patients (≤5 years)(0.91% to 0.14%). Intracranial bleed was also associated with splenectomy (odds ratio [OR] 17.87), and intracranial bleed, gastrointestinal bleed, sepsis, and thrombosis were all associated with longer stay and higher cost of hospitalization.

“Overall, splenectomy rates consistently declined over time. Intracranial hemorrhage during hospitalizations with ITP was associated with occurrence of splenectomy,” the researchers concluded.

—Michael Potts

Reference:

Bhatt NS, Bhatt P, Donda K, et al. Temporal trends of splenectomy in pediatric hospitalizations with immune thrombocytopenia [published online April 2018). Pediatr Blood Cancer. doi: 10.1002/pbc.27072