The following article features coverage from the 61st American Society of Hematology Annual Meeting and Exposition. Click here to read more of Hematology Advisor’s conference coverage.

Rates of intracranial hemorrhage (ICH) have remained stable among patients with immune thrombocytopenia (ITP) between 2007 and 2016, though older patients were at greater risk of the complication, according to research presented at the 61st American Society of Hematology (ASH) Annual Meeting in Orlando, Florida.

Patients with ITP are at heightened risk for ICH, though the frequency of this complication is low. It was, however, previously unclear whether the rate of ICH had increased over time in this patient group and whether there are particular patient features that can predict for it. Researchers analyzed data from the National Inpatient Sample database to determine changes in ICH-related admission between 2007 and 2016 in patients with ITP.

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Data from 348,906 hospitalized patients with ITP between 2007 and 2016 were analyzed. The overall ICH in the cohort was 0.98% (3408 cases), though there was no significant difference in frequency from study commencement to close (P =.3). Patients with ICH had a higher median age compared with those without ICH (63.4 vs 51.6 years; P <.001).

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Although ICH incidence did not increase overall, some subgroups saw decreases or increases of the complication. Patients aged 24 years or younger saw a decreasing incidence over the study period (0.7% to 0.4%), while patients aged 65 years or older, female patients, and those hospitalized in the northeastern United States all saw increases in incidence (0.7% to 0.4%, 1.5% to 1.9%, and 0.9% to 1.1%, respectively).

Mortality among those hospitalized with ICH increased from the period between 2007 and 2008 (28.1%) to the period between 2015 and 2016 (34.6%; P <.001).

Patients with ICH had higher rates of mortality (26.6% vs 3.2%; P <.001), longer hospital stay durations (4.8 vs 2.6 days; P <.001), and greater costs of hospitalization ($20,081 vs $8355; P <.001) compared with patients without ICH.

“The overall incidence of ICH among ITP hospitalizations is low and remained stable from 2007 to 2016, which is reassuring,” the researchers wrote. “Future studies should reassess the ICH trends to study the influence of novel therapeutic options such as thrombopoietin receptor agonists [on ICH incidence].”


1.     Sharma M, Bhatt P, Ayensu M, et al. Temporal trends of intracranial hemorrhage among immune thrombocytopenia hospitalizations in the United States from 2007-2016. Oral presentation at: 61st ASH Annual Meeting and Exposition; December 7-10, 2019; Orlando, FL. Abstract 55.