Outcomes of therapeutic plasma exchange in severe autoimmune hemolytic anemia hospitalizations: An analysis of the National Inpatient Sample

Authors

Ali Abdelhay, Rochester Regional HealthFollow
Amir A. Mahmoud, Rochester Regional HealthFollow
Omar Ammari, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Rami Dalbah, Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA.
Mouna Reghis, Rochester Regional HealthFollow
Anas Hashem, Rochester Regional HealthFollow
Mouaz Alkasem, School of Medicine, University of Jordan, Amman, Jordan.
Mariam Mostafa, Rochester Regional HealthFollow

Department

Internal Medicine

Document Type

Article

Publication Title

Transfusion

Abstract

BACKGROUND: Autoimmune hemolytic anemia (AIHA) is characterized by humoral and/or cellular immune-mediated hemolysis of red blood cells. The role of therapeutic plasma exchange (TPE) in AIHA is unclear.

STUDY DESIGN AND METHODS: We queried the National Inpatient Sample (NIS) for 2002-2019 to identify hospitalizations with the primary diagnosis of AIHA. We included hospitalizations with the highest severity subclass identified by All Patient Refined Disease Related Group (APR-DRG). We used multivariate regression analysis to compare in-hospital mortality and other relevant in-hospital outcomes between hospitalizations that received TPE and those that did not.

RESULTS: We identified 255 weighted hospitalizations in the TPE group and 4973 in the control group. Those in the control group were older (median age 67 vs. 48 years, p < .001) and had a higher prevalence of most comorbidities. The TPE group had higher odds of all-cause in-hospital mortality (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19-2.11). They also had higher rates of many secondary outcomes, including requiring mechanical ventilation, developing circulatory shock, acute stroke, urinary tract infections, intracranial hemorrhage, acute kidney injury, and requiring new hemodialysis. No significant differences were noted in the rates of acute myocardial infarctions, bacterial pneumonia, sepsis/septicemia, thromboembolic events, and other bleeding events. Furthermore, the TPE group had a higher median length of hospital stay (19 vs. 9 days, p < .001).

CONCLUSION: Hospitalizations with severe AIHA that received TPE had higher rates of adverse in-hospital outcomes.

First Page

1376

Last Page

1383

DOI

10.1111/trf.17445

Volume

63

Issue

7

Publication Date

7-1-2023

PubMed ID

37395043

Recommended Citation

Abdelhay, A., Mahmoud, A. A., Ammari, O., Dalbah, R., Reghis, M., Hashem, A., Alkasem, M., & Mostafa, M. (2023). Outcomes of therapeutic plasma exchange in severe autoimmune hemolytic anemia hospitalizations: An analysis of the National Inpatient Sample. Transfusion, 63 (7), 1376-1383. https://doi.org/10.1111/trf.17445