title: Poorer prognosis with ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia: a single-center case-control study.
abstract: In ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP), automated platelet counts are lower than actual counts because of EDTA-induced aggregation. Factors contributing to the incidence of EDTA-PTCP are unknown, and no study has assessed the prognosis of EDTA-PTCP patients. This retrospective study assessed characteristics in EDTA-PTCP patients and matched controls to determine differences in prognosis. A retrospective case-control study was designed. From the University of Tokyo Hospital database, we identified patients diagnosed with EDTA-PTCP between 2009 and 2012, and performed 1:2 case:control matching for age and sex. A control group of sex- and age-matched patients was selected at random from the same database. We investigated differences in the frequency of complications, medication history, and blood transfusion history between the groups at the time of blood collection. Prognosis was evaluated using multivariate Cox regression analysis adjusting for age, sex, autoimmune disease, liver disease, and malignant tumor. We identified 104 EDTA-PTCP patients and 208 matched controls. The median age was 69.0 years (interquartile range: 54-76), with men comprising 51%. EDTA-PTCP patients had a higher frequency of malignant tumor and a lower frequency of hypertension and diabetes than controls. After adjustment for background factors, prognosis of EDTA-PTCP patients was significantly poorer than controls (hazard ratio, 11.8; 95% confidence intervals, 2.62-53.54). In conclusion, EDTA-PTCP patients had higher mortality, and EDTA-PTCP may need to be recognized as an indicator of worse prognosis.
authors.affiliation: From the Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku (NO-F, RI, KN, TW, SN, NY); Department of Emergency Medicine, JR General Hospital, Sibuya-ku, Tokyo (RI); Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi-city, Ibaraki (KN); Department of Health Policy and Technology Assessment, National Institute of Public Health 2-3-6 Minami, Wako, Saitama, Japan (HS); London School of Hygiene and Tropical Medicine, Bloomsbury, London, United Kingdom (MI); and Department of Clinical Laboratory Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan (MJ, TH).
authors.forename: Naoko
authors.initials: N
authors.lastname: Ohashi-Fukuda
authors.forename: Ryota
authors.initials: R
authors.lastname: Inokuchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masao
authors.initials: M
authors.lastname: Iwagami
authors.forename: Tomoki
authors.initials: T
authors.lastname: Wada
authors.forename: Masahiro
authors.initials: M
authors.lastname: Jona
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisasue
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001791:Blood Platelet Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D016022:Case-Control Studies; D015897:Comorbidity; D004492:Edetic Acid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D004492:Edetic Acid