Guest guest Posted February 5, 2010 Report Share Posted February 5, 2010 FULL TEXT: http://www.annals.edu.sg/pdf/39VolNo1Jan2010/V39N1p9.pdf Original Article Thrombocytopenia and its Related Factors: A Hospital-based, Cross-sectional Study Abstract Introduction: The objective of this study was to explore the association between thrombocytopenia and its related factors. Materials and Methods: This was a hospital-based, crosssectional study. We retrospectively analysed the medical records of all patients who received periodic health examinations at a medical centre located at Taichung in Taiwan between 2000 and 2004. In all, 5585 subjects were included for further analysis. A complete physical examination, laboratory survey and abdominal ultrasonography were performed on each subject. The t-test, chi-square test and multivariate logistic regression analysis were used. Results: The subjects consisted of 3123 men (55.9%) and 2462 women (44.1%). The mean age was 49.4 ± 12.3 years (range, 20 to 87). The overall prevalence of thrombocytopenia was found to be 0.5%, higher in men than in women (0.6% vs 0.4%, P = 0.504). After controlling for the other covariates, multivariate logistic regression analysis exhibited that the factors significantly related to thrombocytopenia were increasing age (OR, 1.04; 95% CI, 1.004-1.08), anti-HCV positive (OR, 5.24; 95% CI, 2.08-13.20), liver cirrhosis (OR, 7.93; 95% CI, 2.28-27.62), and splenomegaly (OR, 18.86; 95% CI, 6.86-51.87). Conclusion: It is advisable to further check the hepatic status, if thrombocytopenia is noted. Ann Acad Med Singapore 2010;39:9-12 1 Department of Family Medicine, China Medical University Hospital, Taichung City, Taiwan 2 Department of Family Medicine, Jen-Ai Clinic, Taichung County, Taiwan 3 Department of Internal Medicine, China Medical University Hospital, Taichung City, Taiwan 4 Department of Internal Medicine, Puli Christian Hospital, Nantou County, Taiwan 5 Department of Family Medicine, Private Clinic, Taichung City, Taiwan Address for Correspondence: Dr Kuan-Fu Liao, Department of Internal Medicine, Puli Christian Hospital, No. 1, Tieshan Road, Puli, Nantou County, 545 Taiwan Email: kuanfuliao@... Thrombocytopenia and its Related Factors: A Hospital-based, Cross-sectional Study Shih-Wei Lai,1MD, Ching-Yi Huang,2MD, Hsueh-Chou Lai,3MD, Kuan-Fu Liao,4MD, Yen-Miao Lai,5MD, Chiu-Shong Liu,1MD, Tsann Lin,1MD, PhD Introduction Thrombocytopenia is a common clinical problem found in laboratory results during health examinations. Blood platelets play an essential role in haemostasis, thrombosis and coagulation of blood.1 Platelets are the smallest units of blood cells. They are formed in the bone marrow by the fragmentation of megakaryocyte cytoplasm.2 The normal platelet concentration in adult ranges from 150,000 to 450,000//ìL.3 They circulate in the blood for 8 to 12 days.1,2 Bleeding time is generally not prolonged until the platelet count is below 100,000/ìL.4 However, as long as platelet counts are more than 20,000/ìL, clinical manifestations may be mild, often limited to easy bruising.4 If less than 10,000/ ìL, the risk of spontaneous mucocutaneous bleeding, intracranial haemorrhage or gastrointestinal bleeding increases markedly.2,4 A previous study revealed that thrombopoietin, a ligand for the receptor encoded by protooncogene c-mpl, may play an important role in the regulation of megakaryocyte development and platelet production.5 The production of thrombopoietin is mainly from the liver.6 In Streiff et al's study, patients with hepatitis C infection are more likely to have low platelet counts.7 The hepatitis virus principally replicates in the liver and its cardinal manifestation is progression to chronic liver disease. A decreased production of thrombopoietin in patients with chronic liver disease can result in defi cient platelet production by the bone marrow.8,9 In Taiwan, hepatitis B and hepatitis C infections are hyperendemic, which may lead to liver cirrhosis, and even hepatocellular carcinoma, after many years. We hypothesise a link between the 2 conditions, that patients infected with viral hepatitis may have a higher frequency of thrombocytopenia. To date, there is little evidence of a relationship between thrombocytopenia and its related factors in Taiwan. This study analysed data collected from a medical centre in Taiwan to explore the following questions: (i) what is the prevalence of thrombocytopenia? (ii) what are the related factors of thrombocytopenia? Quote Link to comment Share on other sites More sharing options...
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