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Platelet count is associated with outcome in cancer patients with stroke
Bernardo Cacho-Díaz1, Héctor Spínola-Maroño2, Laura G Mendoza-Olivas2
1Neuro-oncology Unit, Instituto Nacional de Cancerología, Av. San Fernando 22. Col. Sección XVI. Tlalpan, ZC 14080, Mexico City, Mexico. bernardocacho@doctor.com.
Insights
Thrombocytopenia, a low platelet count, is linked to increased mortality in cancer patients experiencing cerebrovascular disease (CVD). This condition, along with altered mental status, significantly raises mortality risk in this vulnerable population.
Area of Science:
- Oncology
- Neurology
- Hematology
Background:
- Cerebrovascular disease (CVD) and cancer are leading causes of mortality globally.
- Thrombocytopenia (low platelet count) is associated with adverse outcomes in cardiovascular and cerebrovascular diseases.
- This study investigates the impact of thrombocytopenia on outcomes for cancer patients with CVD.
Purpose of the Study:
- To assess the relationship between thrombocytopenia and poor outcomes in cancer patients diagnosed with CVD.
- To identify risk factors for mortality in cancer patients with co-existing CVD.
Main Methods:
- Retrospective analysis of 210 cancer patients with CVD treated between 2010-2017.
- Thrombocytopenia defined as platelet count <150,000/mm³ within 24 hours of CVD symptom onset.
- Statistical analysis, including multiple regression, to determine mortality risk factors.
Main Results:
- Thrombocytopenia was significantly associated with shorter overall survival (p<0.001).
- Factors associated with mortality included male sex, hematologic tumors, hemorrhagic CVD, altered mental status, and thrombocytopenia.
- Multiple regression identified thrombocytopenia (RR 1.6) and altered mental status (RR 2.7) as significant mortality risk factors.
Conclusions:
- Thrombocytopenia at CVD diagnosis is linked to higher mortality in cancer patients.
- Altered mental status during initial evaluation is also associated with increased mortality.
- Further research is recommended to confirm these findings.
Introduction:
Cerebrovascular disease (CVD) and cancer are among the most common causes of mortality worldwide, preceded only by ischemic heart disease (IHD). Thrombocytopenia was shown to be associated with poor outcomes in IHD and CVD in the general population. This study aimed to assess the relationship of thrombocytopenia with poor outcomes in cancer patients with CVD.
Materials And Methods:
Data on patients with concomitant CVD and cancer who were initially treated at a cancer referral center between January 2010 and December 2017 were included. Thrombocytopenia was defined as a platelet count < 150,000/mm3 during the first 24 h of CVD symptom onset. The IRB (CI/837/17) approved the review of clinical records.
Results:
Among 268 cancer patients with CVD included in the study, 210 met the inclusion criteria. Median overall survival of the entire cohort was 7.2 months, which was significantly shorter in males (p = 0.029) and patients with hematologic tumors (p = 0.009), hemorrhagic CVD (p < 0.001), altered mental status (p < 0.001), and thrombocytopenia (p < 0.001). Multiple regression logistic analysis revealed that thrombocytopenia (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.4) and altered mental status (RR 2.7, 95% CI 1.9-4.0) remained statistically significant risk factors for mortality.
Conclusion:
In cancer patients with CVD, thrombocytopenia at the time of CVD diagnosis and altered mental status during initial clinical evaluation were associated with higher mortality, which should be confirmed in future studies.
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