A nationwide analysis of outcomes of stroke in hospitalized patients with essential thrombocythemia: 2006 to 2014

Germame Ajebo; Sunny J Patel; Vamsi Kota; Achuta K Guddati

A nationwide analysis of outcomes of stroke in hospitalized patients with essential thrombocythemia: 2006 to 2014

Am J Blood Res. 2020 Aug 25;10(4):76-81. eCollection 2020.

Authors

Germame Ajebo¹, Sunny J Patel², Vamsi Kota¹, Achuta K Guddati¹

Affiliations

¹ Division of Hematology/Oncology, Georgia Cancer Center, Augusta University Augusta, GA 30909, USA.
² Medical College of Georgia, Augusta University Augusta, GA 30909, USA.

PMID: 32923086
PMCID: PMC7486482

Abstract

Background: Essential thrombocythemia (ET) is a subtype of myeloproliferative neoplasm associated with an increased risk of thrombohemorrhagic complications such as stroke. However, studies of prevalence and outcomes of stroke in hospitalized patients with ET have been limited to case series.

Methods: Data from the National Inpatient Sample was utilized to identify outcomes in hospitalized patient with ET who were admitted for stroke. Utilizing the current procedural terminology code (CPT) for ET, outcomes of patients with ET who were hospitalized with stroke were studied for the years 2006 to 2014. Patient demographics of age, gender and race were collected and hospital characteristics of location and size were correlated to outcomes. Chi square test was used to determine odds ratios and multiple logistic regression was used to determine independent predictors of mortality.

Results: Between the years of 2006 to 2014, a total of 552422 hospitalizations involved patients with a diagnosis of ET, 20650 of which were due to stroke. The percentage of stroke in these hospitalizations varied between 3.64 to 4.29 over 9 years and mortality in these patients did not significantly change during this time period. The prevalence of stroke was highest amongst Asians and Caucasians (4.7% and 3.86%) with a statistically significant difference (P=0.0000). A majority of ET patients with stroke were discharged to skilled nursing facilities. Multiple regression showed that female gender, atrial fibrillation, stroke, higher Charlson's comorbidity score and 80+ age were independent predictors of mortality (OR: 0.75, 1.35, 1.8, 2 to 5.7, 13.9 respectively).

Conclusions: This study demonstrated that Female gender, atrial fibrillation, stroke, higher Charlson's comorbidity score and 80+ age group were found to be statistically significant independent predictors of mortality (OR: 0.75, 1.35, 1.8, 2 to 5.7, 13.9 respectively) in patients with ET and stroke. Inclusion of these factors in the risk stratification of patients with ET may decrease the morbidity and mortality associated with the disease.

Keywords: Essential thrombocythemia; outcomes; stroke.