Temporal trends of splenectomy in pediatric hospitalizations with immune thrombocytopenia

Bhatt, N. S.; Bhatt, P.; Donda, K.; Dapaah-Siakwan, F.; Chaudhari, R.; Linga, V. G.; Patel, B.; Lekshminarayanan, A.; Bhaskaran, S.; Zaid-Kaylani, S.; Badawy, S. M.

Pediatr Blood Cancer. 2018 Apr 11; 65(7):e27072

Abstract

BACKGROUND: Splenectomy is considered an effective treatment for immune thrombocytopenia (ITP) with 70-80% response rate. However, its current use is limited in children with ITP. It is unclear if the rates of splenectomy have changed over time. Using a large nationally representative database, we aimed to study the trends of splenectomy in pediatric hospitalizations with ITP, and the factors associated with splenectomy during these encounters. METHODS: Using National (Nationwide) Inpatient Sample (NIS), and international classification of diseases (9th revision), clinical modification (ICD-9-CM) codes, we studied pediatric ITP hospitalizations with occurrence of total splenectomy between 2005 and 2014. RESULTS: Out of 37,844 weighted ITP hospitalizations from 2005 to 2014; total splenectomy was performed in 954 encounters. Splenectomy rate declined over time (3.4% [2005-2006] to 1.6% [2013-2014], P < 0.001) with the younger age (

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