Thrombocytopenia in neonates and the risk of intraventricular hemorrhage: a retrospective cohort study.
Thrombocytopenia in neonates and the risk of intraventricular hemorrhage: a retrospective cohort study.
复制标题
DOI：
10.1186/1471-2431-11-16
复制
发表时间：
2011-02-11
期刊：
影响因子：
2.4
通讯作者：
Walther FJ
中科院分区：
文献类型：
--
作者：
von Lindern JS;van den Bruele T;Lopriore E;Walther FJ
新生儿重症监护室收治的新生儿血小板减少症的总体患病率为 22% 至 35%。只有少数小型研究概述了血小板减少症的严重程度与出血风险之间的关系。这使得很难形成新生儿患者血小板输注的循证阈值。本研究的目的是确定三级新生儿重症监护病房中血小板减少症的患病率，并研究血小板减少症与脑室内出血（IVH）风险之间的关系。我们对 2006 年 1 月至 2008 年 12 月期间入住我们新生儿三级护理托儿所的所有血小板减少症患者进行了回顾性队列研究。根据血小板减少症的严重程度将患者分为 4 组：轻度（100-149 × 109/L）、中度（50-99 × 109/L）、重度（30-49 × 109/L）或极重度（< 30） × 109/L）。主要结局为 IVH ≥ 2 级。分类数据使用 Pearson 卡方检验和 Fischer 精确检验。使用方差分析、逻辑回归分析和多元线性回归进行组间比较和混杂因素。血小板减少症的患病率为 27% (422/1569)。患有血小板减少症的新生儿发生 IVH ≥ 2 级的风险为 12% (48/411)，而无血小板减少症的新生儿发生 IVH ≥ 2 级的风险为 5% (40/844) (p < 0.01)。多元线性回归分析后，血小板减少婴儿亚组发生 IVH ≥ 2 级的风险没有显着差异（p = 0.3）。经过逻辑回归分析后，患有和不患有血小板减少症的新生儿的死亡率差异不显着（p = 0.4）。同样，我们发现血小板减少症新生儿亚组的死亡率没有差异 (p = 0.7)。尽管 IVH ≥ 2 级更常发生在血小板减少的新生儿中，但这种关系与血小板减少的严重程度无关。应进行前瞻性研究，根据潜在的情况评估出血的真实风险。迫切需要随机对照试验来确定血小板输注的安全下限。
The overall prevalence of thrombocytopenia in neonates admitted to neonatal intensive care units ranges from 22 to 35%. There are only a few small studies that outline the relationship between the severity of thrombocytopenia and the risk of bleeding. This makes it difficult to form an evidence-based threshold for platelet transfusions in neonatal patients. The aim of this study was to determine the prevalence of thrombocytopenia in a tertiary neonatal intensive care unit and to study the relation between thrombocytopenia and the risk of intraventricular hemorrhage (IVH). We performed a retrospective cohort study of all patients with thrombocytopenia admitted to our neonatal tertiary care nursery between January 2006 and December 2008. Patients were divided into 4 groups according to the severity of thrombocytopenia: mild (100-149 × 109/L), moderate (50-99 × 109/L), severe (30-49 × 109/L) or very severe (< 30 × 109/L). The primary outcome was IVH ≥ grade 2. Pearson's chi-squared and Fischer's exact tests were used for categorical data. ANOVA, logistic regression analysis and multivariate linear regression were used for comparisons between groups and for confounding factors. The prevalence of thrombocytopenia was 27% (422/1569). Risk of IVH ≥ grade 2 was 12% (48/411) in neonates with versus 5% (40/844) in neonates without thrombocytopenia (p < 0.01). After multivariate linear regression analysis, risk of IVH ≥ grade 2 in the subgroups of thrombocytopenic infants was not significantly different (p = 0.3). After logistic regression analysis the difference in mortality rate in neonates with and without thrombocytopenia was not significant (p = 0.4). Similarly, we found no difference in mortality rate in the subgroups of neonates with thrombocytopenia (p = 0.7). Although IVH ≥ grade 2 occurs more often in neonates with thrombocytopenia, this relation is independent of the severity of thrombocytopenia. Prospective studies should be conducted to assess the true risk of hemorrhage depending on underlying conditions. Randomized controlled trials are urgently needed to determine a safe lower threshold for platelet transfusions.
登录
查看更多内容
影响因子：
--
作者：
Christensen, Robert D
通讯作者：
Christensen, Robert D
影响因子：
8
作者：
Baer, Vickie L.;Lambert, Diane K.;Christensen, Robert D.
通讯作者：
Christensen, Robert D.
影响因子：
2.9
作者：
Del Vecchio, A;Sola, MC;Christensen, RD
通讯作者：
Christensen, RD
影响因子：
3.8
作者：
Sola, MC;Rimsza, LM
通讯作者：
Rimsza, LM
影响因子：
1.5
作者：
Murray, NA;Howarth, LJ;Roberts, IAG
通讯作者：
Roberts, IAG