Frederiksen Henrik, Maegbaek Merete Lund, Nørgaard Mette
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Haematology, Odense University Hospital, Odense, Denmark.
Br J Haematol. 2014 Jul;166(2):260-7. doi: 10.1111/bjh.12869. Epub 2014 Apr 2.
Studies have reported a 1·3- to 2·2-fold higher mortality rate among patients with primary immune thrombocytopenia (ITP) compared to the general population. However, long-term mortality estimates as well as cause-specific mortality data are sparse. In our population-based cohort of adult patients with newly diagnosed ITP and up to 37 years of follow-up, the 5-year, 10-year and 20-year mortality among the ITP patients was 22%, 34% and 49%, respectively. The mortality in the ITP cohort was consistently higher than in the in the general population cohort yielding an adjusted hazard ratio (HR) of 1·5 [95% confidence interval (CI): 1·2-1·8]. The adjusted HRs of mortality due to cardiovascular disease, infection, bleeding and haematological cancer were 1·5 (95% CI: 1·1-1·5), 2·4 (95% CI: 1·0-5·7), 6·2 (95% CI: 2·8-13·5) and 5·7 (95% CI: 2·1-15·7), respectively, whereas mortality due to solid cancer and other causes were similar in ITP patients and the general population. We conclude that mortality rates among ITP patients are higher than in the general population, predominantly as a result of increased cardiovascular disease, infection, bleeding and haematological cancer cause-specific mortalities.
研究报告称，与普通人群相比，原发性免疫性血小板减少症（ITP）患者的死亡率高出1.3至2.2倍。然而，长期死亡率估计以及特定病因的死亡率数据却很稀少。在我们基于人群的成年新诊断ITP患者队列中，随访长达37年，ITP患者的5年、10年和20年死亡率分别为22%、34%和49%。ITP队列中的死亡率始终高于普通人群队列，调整后的风险比（HR）为1.5[95%置信区间（CI）：1.2 - 1.8]。因心血管疾病、感染、出血和血液系统癌症导致的死亡调整后HR分别为1.5（95%CI：1.1 - 1.5）、2.4（95%CI：1.0 - 5.7）、6.2（95%CI：2.8 - 13.5）和5.7（95%CI：2.1 - 15.7），而实体癌和其他原因导致的死亡在ITP患者和普通人群中相似。我们得出结论，ITP患者的死亡率高于普通人群，主要是由于心血管疾病、感染、出血和血液系统癌症导致的特定病因死亡率增加。
