Is essential thrombocytosis associated with worse outcomes in patients with stroke? Results from 2016-2020 National Inpatient Sample study.

Abstract

e23060 Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm. Thrombosis is a major cause of morbidity and mortality in ET. It is unknown whether the morbidity and mortality of ischemic stroke in ET is different from that in non-ET patients. Similarly, the quantitative data regarding the use of platelet pheresis in this population is also unknown. This National Inpatient Sample (NIS) database study aims to answer these questions. Methods: A retrospective analysis of the NIS database from 2016 to 2020 was conducted using ICD-10 codes to identify hospitalizations with ischemic stroke. STATA version SE18.0 was used for statistical analysis. We used multivariate regression analysis to calculate the effects of ET on mortality and length of stay along with various other variables including age, gender, primary payer, household income, Charlson Comorbidity index, hospital bed size, hospital region, diabetes mellitus, heart failure, hypertension, coronary artery disease, smoking, hyperlipidemia, carotid artery stenosis, and atrial fibrillation. Results: There were 2,635,595 hospitalizations with primary diagnosis of ischemic stroke. Among these, 9604 patients had secondary diagnosis of ET. The mean age of ET patients with stroke was 67 years. 60.5% of patients were females. 40 (0.41%), 335 (3.48%) and 720 (7.49%) patients underwent plateletpheresis, thrombectomy, and thrombolysis respectively. Multivariate logistic regression showed that ET was not associated with increased mortality, but was associated with significantly increased length of stay with odds ratio (OR) of 0.95 [95% confidence interval (CI) = 0.73 to 1.23, p-value = 0.7) and 2.58 (95% CI = 2.12 to 3.04, p-value = 0.00) respectively. The effect of other pertinent variables are summarized in Table 1. Conclusions: Our analysis shows that stoke in ET was not associated with increased mortality. ET was associated with increased length of stay in patients with stroke. 0.41% of ET patients with stroke received platelet pheresis. Limitations of this study include failure of the multivariate model to account for all the variables, coding errors, and increased risk of bias due to retrospective nature of the data. [Table: see text]