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Home All Specialties Pediatrics

Children still hospitalized and treated for ITP despite conservative guidelines

bys25qthea
April 8, 2013
in Pediatrics
Reading Time: 2 mins read
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Image: PD

1. Most hospitalized children with newly diagnosed immune thrombocytopenia (ITP) were given pharmacological therapy, with intravenous immunoglobulin (IVIG) being the most common. 

2. Management of newly diagnosed ITP differed by geographic location in US children’s hospitals. 

Study Rundown: Recent evidence-based guidelines for the management of ITP, an autoimmune disease characterized by increased bleeding risk, suggest conservative, observation-based care. This study evaluated 2314 pediatric patients with newly diagnosed ITP at freestanding US children’s hospitals to examine current practices in the context of the new guidelines. Using data from the Pediatric Health Information System (PHIS), a large database from 43 US children’s hospitals, it was determined that many hospitalized patients were given pharmacological therapy. IVIG was the most commonly used therapy, despite being the most expensive. A small portion of patients had noncutaneous bleeding and few experienced the most concerning ITP-related complication, intracranial hemorrhage. Significant differences in approach and costs were observed between freestanding US children’s hospitals. Limitations to the study included a lack of comparison to patients managed in an outpatient setting, which would better elucidate reasons for hospitalization. Findings suggest further evaluation of national practices to better align with recent guidelines recommending conservative, observation-based care over broad pharmacological therapy.

Click to read the study, published today in Pediatrics

In-depth [retrospective analysis]: The study examined the management of 2314 pediatric patients with newly diagnosed ITP at freestanding US children’s hospitals through the PHIS database. 90% of hospitalized patients were medically treated, with 78% receiving IVIG compared to anti-D immunoglobulin and corticosteroid treatments. Noncutaneous bleeding occurred in 12% of cases with epistaxis being the most common manifestation in 7.8% of patients. Intracranial bleeding was observed in only 0.6% of cases. Mortality rate was 0.1% in admitted patients. Significant regional differences in approach and costs were observed amongst freestanding US children’s hospitals with IVIG use ranging from 66.2%-85.0% and total hospital charges ranging from $7194-11409. 

By Neha Joshi and Leah H. Carr

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More from this author: Parent behavior training treats preschoolers at risk for ADHD, AAP supports same-sex marriage and parenting, Low birth weight children show neurobehavioral impairments, Study explores daily iron supplementation in 2- to 5-year-olds, New guidelines for pediatric acute otitis media released 

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain. 

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