Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2010-1-12
pubmed:abstractText
The treatment of immune thrombocytopenic purpura (ITP) still offers challenges to clinicians and health professional organizations, despite recommendations provided by international guidelines. In order to improve the care of patients with ITP, it is useful to understand how often such patients receive appropriate treatment and if common errors occur that could be avoided. We retrospectively analyzed all the clinical records between 1 January, 2000 and 31 December, 2002 of patients receiving an ICD-9-CM diagnosis code of 287.3 in three hospitals in northern Italy. We examined whether management strategies of adult men and nonpregnant women with ITP were consistent or not with the guidelines provided by the American Society of Hematology. The ITP diagnosis was confirmed in 120 of 169 patients (71%). Reasons for admission were: medical treatment for ITP (51.7%), medical or surgical treatment of ITP-associated disorders (30.8%), elective splenectomy (15.8%) and diagnosis or observation of ITP (1.7%). Hospital admission resulted appropriate in 78.1% of cases. Therapeutic interventions were appropriate in 100% of cases for glucocorticoid treatment, 86.4% for splenectomy, 47.7% for high-dose immunoglobulins, 40.9% for prophylaxis against bleeding before splenectomy, 33.3% for high-dose glucocorticoid treatment, and 19% for prophylaxis against bacterial infections before splenectomy. Platelet transfusions as treatment for bleeding were appropriate in only 20% of cases. Confirming the usefulness of the American guidelines for ITP, our data suggest that there are important areas of inappropriate management of the disease, which could be corrected by adopting quality improvement programs and studies.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1473-5733
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
21
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
77-84
pubmed:meshHeading
pubmed-meshheading:19858712-Adult, pubmed-meshheading:19858712-Antibiotic Prophylaxis, pubmed-meshheading:19858712-Combined Modality Therapy, pubmed-meshheading:19858712-Disease Management, pubmed-meshheading:19858712-Female, pubmed-meshheading:19858712-Glucocorticoids, pubmed-meshheading:19858712-Guideline Adherence, pubmed-meshheading:19858712-Hospitalization, pubmed-meshheading:19858712-Humans, pubmed-meshheading:19858712-Immunoglobulins, Intravenous, pubmed-meshheading:19858712-Immunosuppressive Agents, pubmed-meshheading:19858712-Italy, pubmed-meshheading:19858712-Male, pubmed-meshheading:19858712-Medical Audit, pubmed-meshheading:19858712-Middle Aged, pubmed-meshheading:19858712-Patient Admission, pubmed-meshheading:19858712-Platelet Transfusion, pubmed-meshheading:19858712-Practice Guidelines as Topic, pubmed-meshheading:19858712-Purpura, Thrombocytopenic, Idiopathic, pubmed-meshheading:19858712-Retrospective Studies, pubmed-meshheading:19858712-Splenectomy, pubmed-meshheading:19858712-Unnecessary Procedures, pubmed-meshheading:19858712-Young Adult
pubmed:year
2010
pubmed:articleTitle
Appropriate hospital management of adult immune thrombocytopenic purpura patients in major Italian institutions in 2000-2002: a retrospective analysis.
pubmed:affiliation
Divisione Medica II dell'Ospedale Niguarda Ca' Granda, Milano, Italy. cirasino@telnetwork.it
pubmed:publicationType
Journal Article, Multicenter Study