Literature DB >> 27387823

High Rates of Bleeding Complications among Hospitalized Patients with Hereditary Hemorrhagic Telangiectasia in the United States.

Waleed Brinjikji1, Christopher P Wood1, Giuseppe Lanzino2, Harry J Cloft1, Sanjay Misra1, David F Kallmes1, Patrick Kamath3, Rajiv K Pruthi4, Michael J Krowka5, Karen L Swanson6, Vivek N Iyer5.   

Abstract

RATIONALE: There is sparse published literature on the causes and outcomes of hospitalization of patients with hereditary hemorrhagic telangiectasia (HHT).
OBJECTIVES: To evaluate rates of various complications, comorbidities, and in-hospital outcomes of patients with HHT using a large, multihospital inpatient database.
METHODS: We identified patients with HHT in the U.S. Nationwide Inpatient Sample between 2000 and 2012. Rates of hemorrhagic, neurological, hepatic, and cardiopulmonary complications among hospitalized patients with HHT were evaluated. We also studied procedure use rates for blood transfusion, endoscopy, and epistaxis treatment. Hospitalization outcomes, including in-hospital mortality, discharge status, charges, and length of stay, were evaluated.
MEASUREMENTS AND MAIN RESULTS: We identified 10,293 patients with HHT. The mean age of the HHT population was 60.7 years. Sixty percent of patients were female. More than 75% of HHT hospitalizations occurred in those older than 50 years of age. Patients with HHT had high rates of bleeding-related complications, including anemia (53.3%), epistaxis (16.2%), and gastrointestinal bleeding (10.8%). Overall, bleeding complications accounted for 62.7% of HHT-related complications. Thirty-eight percent of hospitalized patients with HHT received one or more transfusions of a blood product. Cardiopulmonary complications were present in 41.0% of the cases. Congestive heart failure was the second most common individual complication among patients with HHT, affecting 19.9% of patients. The in-hospital mortality rate was 1.9%.
CONCLUSIONS: In this large, nationwide study, we found that nearly two-thirds of patients hospitalized with HHT experienced a bleeding-related complication. Nearly 40% of hospitalized patients with HHT required transfusion of blood products. Cardiopulmonary complications, including congestive heart failure, were the second most common complication. The high burden of bleeding-related complications points to a significant unmet clinical need for these patients.

Entities:  

Keywords:  anemia; bleeding; epidemiology; hemorrhage; hereditary hemorrhagic telangiectasia

Mesh:

Year:  2016        PMID: 27387823     DOI: 10.1513/AnnalsATS.201603-200OC

Source DB:  PubMed          Journal:  Ann Am Thorac Soc        ISSN: 2325-6621


  11 in total

1.  Basal Ganglia T1 Hyperintensity in Hereditary Hemorrhagic Telangiectasia.

Authors:  A Parvinian; V N Iyer; B S Pannu; D R Apala; C P Wood; W Brinjikji
Journal:  AJNR Am J Neuroradiol       Date:  2017-08-03       Impact factor: 3.825

2.  Comorbidity among HHT patients and their controls in a 20 years follow-up period.

Authors:  Katrine Saldern Aagaard; Anette Drøhse Kjeldsen; Pernille Mathiesen Tørring; Anders Green
Journal:  Orphanet J Rare Dis       Date:  2018-12-14       Impact factor: 4.123

3.  Pazopanib may reduce bleeding in hereditary hemorrhagic telangiectasia.

Authors:  Marie E Faughnan; James R Gossage; Murali M Chakinala; S Paul Oh; Raj Kasthuri; Christopher C W Hughes; Justin P McWilliams; Joseph G Parambil; Nicholas Vozoris; Jill Donaldson; Gitanjali Paul; Pamela Berry; Dennis L Sprecher
Journal:  Angiogenesis       Date:  2018-09-06       Impact factor: 9.596

4.  Safety of direct oral anticoagulants in patients with hereditary hemorrhagic telangiectasia.

Authors:  C L Shovlin; C M Millar; F Droege; A Kjeldsen; G Manfredi; P Suppressa; S Ugolini; N Coote; A D Fialla; U Geisthoff; G M Lenato; H J Mager; F Pagella; M C Post; C Sabbà; U Sure; P M Torring; S Dupuis-Girod; E Buscarini
Journal:  Orphanet J Rare Dis       Date:  2019-08-28       Impact factor: 4.123

5.  Healthcare Utilization and Costs associated with Hereditary Hemorrhagic Telangiectasia Patients in a Large US Claims Database.

Authors:  Hasan Ahmad Hasan Albitar; Holly Van Houten; Lindsey R Sangaralingham; Meghan Knoedler; Yahya Almodallal; Adham K Alkurashi; Alice Gallo De Moraes; Hector Cajigas; Hillary DuBrock; Deepti Warad; Nadir Demirel; Michael Krowka; Waleed Brinjikji; Vivek N Iyer
Journal:  Mayo Clin Proc Innov Qual Outcomes       Date:  2020-11-20

6.  Predictors of mortality in patients with hereditary hemorrhagic telangiectasia.

Authors:  K P Thompson; J Nelson; H Kim; L Pawlikowska; D A Marchuk; M T Lawton; Marie E Faughnan
Journal:  Orphanet J Rare Dis       Date:  2021-01-06       Impact factor: 4.123

7.  Weekly epistaxis duration as an indicator of epistaxis severity in hereditary hemorrhagic telangiectasia-Preliminary results from a randomized controlled trial.

Authors:  Vincent Wu; John M Lee; Nicholas T Vozoris; Marie E Faughnan
Journal:  Laryngoscope Investig Otolaryngol       Date:  2021-04-08

8.  Management of Refractory Gastrointestinal Bleeding in Hereditary Hemorrhagic Telangiectasia with Bevacizumab.

Authors:  Muaaz Masood; Michael Coles; Humberto Sifuentes
Journal:  Case Rep Gastrointest Med       Date:  2021-06-29

9.  Diffuse telangiectasia of the colon: A case report.

Authors:  Jun-An Li; Li-Li Zhong; Bo Li; Dong-Qiang Jiang; Yin-Long Zhao
Journal:  Medicine (Baltimore)       Date:  2020-08-21       Impact factor: 1.817

10.  An international, multicenter study of intravenous bevacizumab for bleeding in hereditary hemorrhagic telangiectasia: the InHIBIT-Bleed study.

Authors:  Hanny Al-Samkari; Raj S Kasthuri; Joseph G Parambil; Hasan A Albitar; Yahya A Almodallal; Carolina Vázquez; Marcelo M Serra; Sophie Dupuis-Girod; Craig B Wilsen; Justin P McWilliams; Evan H Fountain; James R Gossage; Clifford R Weiss; Muhammad A Latif; Assaf Issachar; Meir Mei-Zahav; Mary E Meek; Miles Conrad; Josanna Rodriguez-Lopez; David J Kuter; Vivek N Iyer
Journal:  Haematologica       Date:  2021-08-01       Impact factor: 9.941

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