Immune thrombocytopenia in adults: Epidemiology, clinical course, prognostic factors in two third level institutions of Antioquia, 2012–2018: Cohort follow-up study

Abstract

IntroductionPrimary immune thrombocytopenia (pITP) is a hematological disorder characterized by the destruction of platelets by an immunological phenomenon. The main therapeutic objective is the rapid and sustained increase in platelet count to reduce the risk of bleeding. There are discrepancies between the prognostic factors in children and adult patients. ObjectiveTo determine the prognostic factors (clinical, laboratory, sociodemographic) for the development of chronic and persistent pITP in adults in two institutions of the Department of Antioquia 2012–2018. Materials and methodsObservational, analytical study, longitudinal design based on information obtained from a cohort of patients. Bivariate and multivariate analysis techniques (logistic regression) are used to study predictors and model development. ResultsChronic persistent pITP corresponds to 65% of patients, predominantly women (82%). There is an association with chronicity between the variables of symptom times greater than 15 days (OR: 5.45; 95% CI: 2.3–12.5), dexamethasone treatment (OR: 0.074; 95% CI: 0.023–0.23), prednisolone treatment (OR: 0.35; 95% CI: 0.125–1.034). A predictive model was developed, including variables: time of symptoms and treatment (sensitivity of 87.5%, specificity of 52.94%, PPV 78%, NPV 69%), and 3 risk groups were estimated. ConclusionsThere are clinical and paraclinical factors that can predict the risk of chronicity for pITP in the adult population; these findings must be confirmed by prospective studies and external validation of the multivariate model proposed in the present investigation.