Platelet Transfusion Is Associated With Increased Thrombosis and In-Hospital Mortality Among Patients Hospitalized...

Area of Science:

• Hematology
• Critical Care Medicine
• Thrombosis Research

Background:

• Platelet transfusions are standard for bleeding risk in platelet consumptive disorders.
• Platelets may paradoxically promote thromboinflammation.
• Limited data exist on transfusion impact on thrombosis and mortality in these patients.

Purpose of the Study:

• To evaluate the association between platelet transfusion and outcomes in hospitalized patients with platelet consumptive disorders.
• To assess the impact of platelet transfusion on in-hospital mortality and thrombotic events.

Main Methods:

• Retrospective cohort study using the National Inpatient Sample (2018-2021).
• Included non-elective hospitalizations for immune thrombocytopenic purpura, thrombotic thrombocytopenic purpura, heparin-induced thrombocytopenia, and other primary thrombocytopenias.
• Used inverse probability of treatment weighting and logistic regression to adjust for confounders.

Main Results:

• Platelet transfusion was associated with increased in-hospital mortality (aOR, 1.42) and thrombosis (aOR, 1.28).
• Increased odds of both venous (aOR, 1.39) and arterial thrombosis (aOR, 1.15) were observed.
• Thrombotic risk persisted without major bleeding but was attenuated with major bleeding.

Conclusions:

• Platelet transfusion in hospitalized patients with platelet consumptive disorders is linked to higher in-hospital thrombosis and mortality.
• Findings support cautious, indication-based platelet transfusion practices.