{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:20:48Z","timestamp":1787016048250,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T00:00:00Z","timestamp":1543968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The role of platelet transfusions in management of Immune Thrombocytopenia (ITP) remains controversial. Current guidelines recommend that platelet transfusions in ITP be reserved for catastrophic hemorrhage or invasive surgical procedures. This study assesses the nationwide platelet transfusion practices in hospitalized children and adults with ITP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We studied hospitalizations with ITP as the primary admitting diagnosis from 2010\u20132014 in National Inpatient Sample (NIS), the largest all\u2010payer inpatient database. Univariate and multivariable logistic regression analyses were used to determine factors predicting platelet transfusions. Sampling weights were applied to generate nationally representative estimates. Propensity score matching was used to perform sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>From 2010 to 2014, there were 78,376 admissions with ITP as the primary admission diagnosis (mean \u00b1 SD age: 45 \u00b1 27 years; females 56%, children [age &lt; 18 years] 22%) and 282,285 with ITP as one of all the admission diagnoses. Overall, 27% admissions with ITP as primary (children 4%) and 15% admissions with ITP as one of all the diagnoses documented at least one platelet transfusion. On multivariable adjustment the following factors were associated with worsening disease severity and a higher odds of platelet transfusion, adult age (adjOR = 9.03, 95% CI = 7.40\u201311.02), male gender (adjOR = 1.21, 95% CI = 1.11\u20131.31), bleeding occurrence (intracranial\/gastrointestinal\/genitourinary\/epistaxis) (adjOR = 1.78, 95% CI = 1.61\u20131.96), admission to rural non\u2010teaching hospital (adjOR = 1.85, 95% CI = 1.52\u20132.22), and small bed\u2010size hospital (adjOR = 1.23, 95% CI = 1.05\u20131.45). Of admissions reporting platelet transfusions, only 26% reported a bleeding complication, and 11% had a major operating\u2010room surgery\/procedure. Overall, 65% of transfused patients had neither bleeding nor a major operative procedure during the hospitalization. Admissions with platelet transfusions had a significantly longer mean length of hospitalization 2.2 days (95% CI = 1.96\u20132.41, p &lt; 0.001), and accrued higher mean total hospital charges; $31,150 USD (95% CI = 27,644\u201334,656, p &lt; 0.001). However, platelet transfusions were not associated with in\u2010hospital mortality (adjOR = 1.02, 95% CI = 0.73\u20131.45, p = 0.892).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Platelets are administered to a small fraction of the hospitalized ITP patients. In a majority of these cases however, platelet usage does not appear to be concordant with the current guidelines or associated with improvement in clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.15069","type":"journal-article","created":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T23:15:17Z","timestamp":1544051717000},"page":"169-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Platelet transfusion practices in immune thrombocytopenia related hospitalizations"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9905","authenticated-orcid":false,"given":"Ruchika","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Pathology Johns Hopkins University  Baltimore Maryland"},{"name":"Division of Hematology Oncology, Simmons Cancer Institute at SIU School of Medicine  Springfield Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurav","family":"Chopra","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Iowa School of Medicine  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron A. R.","family":"Tobian","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology\/Critical Care Medicine and the Armstrong Institute for Patient Safety and Quality Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-1494","authenticated-orcid":false,"given":"Melissa","family":"Cushing","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7759-4546","authenticated-orcid":false,"given":"Ljiljana","family":"Vasovic","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipra","family":"Kaicker","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra D.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia"},{"name":"Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics, Division of Hematology\/Oncology Emory University School of Medicine  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Nellis","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Bussel","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmanan","family":"Krishnamurti","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics, Division of Hematology\/Oncology Emory University School of Medicine  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra010501"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e3282ab98c7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-08-302984"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225565"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-12-4598"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04131.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1542\/peds.59.1.49","article-title":"Use of homologous platelet survival in differential diagnoses of chronic thrombocytopenia in childhood","volume":"59","author":"Buchanan GR","year":"1977","journal-title":"Pediatrics"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V65.3.584.584"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1001\/jama.1976.03270170013015","article-title":"Platelet transfusion in immune thrombocytopenic purpura","volume":"236","author":"Abrahm J","year":"1976","journal-title":"JAMA"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(86)90664-9"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-6-808"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-8652(200009)65:1<85::AID-AJH17>3.0.CO;2-9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH08-06-0418"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21060"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21500"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-605493"},{"key":"e_1_2_7_18_1","unstructured":"Healthcare Cost and Utilization Project (HCUP). 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