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Assessment of Bleeding in Patients with Haematological Malignancies and the Association between Platelet Count and Bleeding
Author(s) -
Dyer C.,
Casbard A.,
Murphy M.,
Stanworth S.
Publication year - 2006
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2006.00693_29.x
Subject(s) - medicine , platelet , incidence (geometry) , prospective cohort study , major bleeding , platelet transfusion , morning , physics , myocardial infarction , optics
Aim To evaluate methods to collect bleeding outcomes in thrombocytopenic patients, including by patient self‐assessment, and to investigate the association between platelet count and bleeding. Methods Consecutive patients with haematological malignancies were enrolled in a study of bleeding data collection, platelet counts and transfusions during the period of thrombocytopenia. An educational session and information sheet was designed for patient self‐assessment. Results A total of 19 patients were included in the study. 410 days of thrombocytopenia were eligible for assessment of bleeds. Self‐assessment was deemed feasible, as self‐assessment was successfully completed on 288/410 (70%) of thrombocytopenic days. There was 86% agreement between bleeding data collected by both self‐assessment and medical examination, using a structured assessment form. Examples of discrepancies included the duration of petechiae/bruises and the reporting of minor bleeding. There was no evidence for an association between patients’ morning platelet count and daily WHO bleeding grade. Bleeding events were compared for platelet counts of ≤10 × 10 9 L −1 , 11–20 × 10 9 L −1 , and >20 × 10 9 L −1 . The incidence of WHO Grade one and two bleeds were similar and did not reveal higher rates of bleeding at lower counts 1 . Conclusion Patient self‐assessment can help support comprehensive daily prospective monitoring of bleeding, specifically facilitating data collection following hospital discharge. Exact definitions for bleeding events remains problematic. The association between platelet count, risk of bleeding and role of prophylactic platelet transfusions needs further evaluating in larger prospective trials. Reference 1 Stanworth S.J., Dyer C, Casbard A & Murphy M. (2006) Vox Sang. 91 63–9