title: Characteristics and outcome of immune thrombocytopenia in elderly: results from a single center case-controlled study.
abstract: The management of ITP in elderly raises several questions that have not been fully addressed in the literature. To assess the impact of ITP in elderly, a case-control study was performed. The main characteristics at onset and the outcome of ITP in 55 patients aged of 70 years and above (cases) were compared with those of 97 younger adults (controls) seen at the same tertiary referral institution. The mean age at diagnosis was respectively 77.8±6.1 years (cases) and 40.3±14.9 years (controls). While the median platelet count at time of diagnosis was not significantly different in cases and controls (6×10(9) /L, range: 2-26 versus 12×10(9) /L: 5-21.5), bleeding symptoms were more frequent in cases (82%) than in the controls (68%, p=0.07), and the median bleeding score was significantly higher in elderly (p=0.001). The rate of treatment-related adverse events was more than twofold higher in elderly patients and the mean cumulative duration of hospital stay for ITP during the follow-up period was much longer when compared to the controls (p<0.0001). Three ITP-related deaths (5.4%) including 1 from intracranial hemorrhage occurred in the cases but none in the controls. In conclusion, this study confirms that at equivalent platelet count, ITP has a greater impact in elderly.
authors.affiliation: Department of Internal Medicine, national referral center for adult's immune cytopenias, Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France. marc.michel@hmn.aphp.fr
authors.forename: Marc
authors.initials: M
authors.lastname: Michel
authors.forename: Odile Beyne
authors.initials: OB
authors.lastname: Rauzy
authors.forename: Francoise Roudot
authors.initials: FR
authors.lastname: Thoraval
authors.forename: Laetitia
authors.initials: L
authors.lastname: Languille
authors.forename: Mehdi
authors.initials: M
authors.lastname: Khellaf
authors.forename: Philippe
authors.initials: P
authors.lastname: Bierling
authors.forename: Bertrand
authors.initials: B
authors.lastname: Godeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome