The ISTH bleeding assessment tool as predictor of bleeding events in inherited platelet disorders: Communication from the ISTH SSC Subcommittee on Platelet Physiology.
bleeding prediction
bleeding score
inherited platelet disorders
mild-moderate bleeding disorders
von Willebrand disease
Journal
Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
18
01
2021
received:
29
10
2020
accepted:
04
02
2021
entrez:
21
4
2021
pubmed:
22
4
2021
medline:
22
5
2021
Statut:
ppublish
Résumé
The ISTH Bleeding Assessment Tool (ISTH-BAT) has been validated for clinical screening of suspected von Willebrand disease (VWD) and for bleeding prediction. Recently it has been validated for subjects with inherited platelet disorders (IPD) (BAT-VAL study). To determine whether the ISTH-BAT bleeding score (BS) predicts subsequent bleeding events requiring treatment in IPD patients. Patients with IPD, type 1 VWD (VWD-1) and age- and sex-matched healthy controls enrolled in the BAT-VAL study were prospectively followed-up for 2 years and bleeding episodes requiring treatment were recorded. Of the 1098 subjects initially enrolled, 955 were followed-up and 124 suffered hemorrhages during follow-up, 60% of whom had inherited platelet function disorders (IPFD). Total number of events was significantly higher in IPFD (n = 235) than VWD-1 (n = 52) or inherited thrombocytopenia (IT; n = 20). Events requiring transfusions were 66% in IPFD, 5.7% in VWD-1, and 3% in IT. Baseline BS was significantly higher in IPFD patients with a bleeding event at follow-up than in those without (p < .01) and the percentage of subjects suffering a bleeding event increased proportionally to baseline BS quartile. A significant association between the BS and the chance of suffering severe bleeding was found in the overall, IPFD, and VWD-1 populations. Similar results were obtained for the pediatric population. Inherited platelet function disorder patients with high BS at enrollment are more likely to suffer from bleeding events requiring treatment at follow-up. Moreover, the higher the baseline BS quartile the greater the incidence of subsequent events, suggesting that independently from diagnosis a high BS is associated with a greater risk of subsequent hemorrhage.
Sections du résumé
BACKGROUND
The ISTH Bleeding Assessment Tool (ISTH-BAT) has been validated for clinical screening of suspected von Willebrand disease (VWD) and for bleeding prediction. Recently it has been validated for subjects with inherited platelet disorders (IPD) (BAT-VAL study).
OBJECTIVES
To determine whether the ISTH-BAT bleeding score (BS) predicts subsequent bleeding events requiring treatment in IPD patients.
METHODS
Patients with IPD, type 1 VWD (VWD-1) and age- and sex-matched healthy controls enrolled in the BAT-VAL study were prospectively followed-up for 2 years and bleeding episodes requiring treatment were recorded.
RESULTS
Of the 1098 subjects initially enrolled, 955 were followed-up and 124 suffered hemorrhages during follow-up, 60% of whom had inherited platelet function disorders (IPFD). Total number of events was significantly higher in IPFD (n = 235) than VWD-1 (n = 52) or inherited thrombocytopenia (IT; n = 20). Events requiring transfusions were 66% in IPFD, 5.7% in VWD-1, and 3% in IT. Baseline BS was significantly higher in IPFD patients with a bleeding event at follow-up than in those without (p < .01) and the percentage of subjects suffering a bleeding event increased proportionally to baseline BS quartile. A significant association between the BS and the chance of suffering severe bleeding was found in the overall, IPFD, and VWD-1 populations. Similar results were obtained for the pediatric population.
CONCLUSIONS
Inherited platelet function disorder patients with high BS at enrollment are more likely to suffer from bleeding events requiring treatment at follow-up. Moreover, the higher the baseline BS quartile the greater the incidence of subsequent events, suggesting that independently from diagnosis a high BS is associated with a greater risk of subsequent hemorrhage.
Identifiants
pubmed: 33880867
doi: 10.1111/jth.15263
pii: S1538-7836(22)00745-0
doi:
Substances chimiques
von Willebrand Factor
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1364-1371Investigateurs
Carlo Zaninetti
(C)
Mathieu Fiore
(M)
Alberto Tosetto
(A)
Pamela Zuniga
(P)
Koji Miyazaki
(K)
Arnaud Dupuis
(A)
Catherine Hayward
(C)
Alessandra Casonato
(A)
Elvira Grandone
(E)
Maria Gabriella Mazzucconi
(MG)
Paula James
(P)
Fabrizio Fabris
(F)
Yvonne Henskens
(Y)
Mariasanta Napolitano
(M)
Jennifer Curnow
(J)
Vasiliki Gkalea
(V)
Marian Fedor
(M)
Michele P Lambert
(MP)
Barbara Zieger
(B)
Luca Barcella
(L)
Benilde Cosmi
(B)
Paola Giordano
(P)
Claudia Porri
(C)
Federica Melazzini
(F)
Madiha Abid
(M)
Ana C Glembotsky
(AC)
Grazia Ferrara
(G)
Alexandra Russo
(A)
Hans Deckmyn
(H)
Andrew L Frelinger
(AL)
Paul Harrison
(P)
Diego Mezzano
(D)
Andrew D Mumford
(AD)
Marie Lordkipanidzé
(M)
Informations de copyright
© 2021 International Society on Thrombosis and Haemostasis.
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