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Prognostic factors for positive immune thrombocytopenic purpura outcome after laparoscopic splenectomy

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Kiudelis M., Mickevicius A., Dambrauskiene R., Gerbutavicius R., Griniūtė R., Adukauskiene D.

Open Medicine

2011

vol. 6

issue 1

123-130

Laparoscopic splenectomy is considered as a second step treatment for ITP patients. The purpose of this study was to determine efficiency of laparoscopic splenectomy for ITP patients and to identify the independent prognostic factors that may predict the positive outcome. Two hundred and thirty nine patient medical records were analyzed retrospectively. The special questionnaire, which included present platelet count, the steroid usage and its dosage, was sent to all patients. The complete response (CR) was defined, when the platelet count was above 130 × 109 /L. The 239 adult patients with a median age of 51.3 (16–93 years) were included in this cohort. The median follow up period was 75 months. 49 patients, who relapsed after steroid treatment, underwent laparoscopic splenectomy. The short term postoperative CR was 71.4% after laparoscopic splenectomy compared to 38.1% in non-splenectomized patients (p < 0.000). The long term CR was 79.5 % in patients after splenectomy compared to 47.4% in non-splenectomized patients (p < 0.018). After univaried analysis three clinical variables were found to be significantly related to splenectomy outcome: disease duration (p<0.007), preoperative platelet count (p<0.049) and platelet count on the third postoperative day (p<0.000). Multiple logistic regression analysis demonstrated, that only platelet count on the 3rd postoperative day > 129 × 109 /L; RR=53.3 95% (CI, 1.888–1517.98) was significant predictor for long-term positive ITP outcome after laparoscopic splenectomy. Splenectomy is effective treatment for ITP. Platelet count > 129 × 109/L on the third postoperative day is the significant predictor of positive long-term outcome after laparoscopic splenectomy.

Platelet count in elderly patients with unipolar depression – case control analysis

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Wysokiński A., Socha K., Sołtysik B. K., Kłoszewska I., Sobów T., Kostka T.

Psychiatria i Psychologia Kliniczna

2018

vol. 18

issue 1

19-24

Aim: While the effect of antidepressants on platelet functions is relatively well studied, there are few studies comparing platelet parameters, such as platelet count, between elderly patients with unipolar depression and non-depressed elderly subjects. Therefore, the aim of the study was to determine if there are differences in platelet count in elderly patients with unipolar depression (DEP) compared with non-depressed elderly patients (nonDEP) using case-control analysis. Methods: We measured platelet count in 582 (DEP: n = 291, nonDEP: n = 291) Caucasian in-patients aged ≥60. The mean age of the study subjects was 77.2 years, there were 243 (83.5%) women in both study groups. Results: The mean platelet count was significantly (p = 0.02) lower in the DEP group (241.6 ± 82.0) compared with the nonDEP group (263.6 ± 107.2). We also found that platelet count was not correlated with age. Conclusions: Compared with non-depressed controls, elderly patients with depression have decreased number of platelet cells. This, combined with the known effect of antidepressants on platelet agreeability, may translate into an increased risk of bleeding complications in the course of antidepressive treatment in elderly patients. Careful monitoring of platelet parameters is therefore recommended in the clinical population of elderly depressed patients.

Cel: O ile wpływ leków przeciwdepresyjnych na funkcje płytek krwi jest stosunkowo dobrze zbadany, o tyle niewiele jest badań porównujących parametry płytek krwi (takie jak liczba płytek krwi) u osób w podeszłym wieku z depresją jednobiegunową i bez depresji. Celem badania było określenie, czy istnieją różnice w liczbie płytek u pacjentów w podeszłym wieku z depresją jednobiegunową (DEP) w porównaniu z pacjentami w podeszłym wieku (nonDEP), za pomocą metody analizy case control. Metody: Oceniono liczbę płytek krwi u 582 (DEP: n = 291, nonDEP: n = 291) pacjentów rasy kaukaskiej w wieku ≥60 lat. Średni wiek badanych wynosił 77,2 roku, w obu grupach było 243 (83,5%) kobiet. Wyniki: Średnia liczba płytek krwi była istotnie statystycznie mniejsza (p = 0,02) w grupie DEP (241,6 ± 82,0) w porównaniu z grupą nonDEP (263,6 ± 107,2). Stwierdzono ponadto, że liczba płytek krwi nie korelowała z wiekiem. Wnioski: W porównaniu z grupą kontrolną u pacjentów w podeszłym wieku z depresją liczba płytek krwi była mniejsza. Fakt ten, w połączeniu ze znanym wpływem leków przeciwdepresyjnych na agregację płytek krwi, może przełożyć się na zwiększone ryzyko wystąpienia powikłań krwotocznych w trakcie leczenia przeciwdepresyjnego u pacjentów w podeszłym wieku. Zaleca się ostrożne monitorowanie parametrów płytek w populacji klinicznej u pacjentów w podeszłym wieku.

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1 Socha K.

1 Sołtysik B. K.

1 Wysokiński A.

Search results

Prognostic factors for positive immune thrombocytopenic purpura outcome after laparoscopic splenectomy

Platelet count in elderly patients with unipolar depression – case control analysis