Evidence map›Paper›PMID 40203187›Full record

ArticleBlood advances2025

Critical bleeding in adults and children with immune thrombocytopenia: a multicenter cohort study.

Emily Sirotich, Saifur R Chowdhury, Dimpy Modi, Gordon Guyatt, Melanie St John, Kerolos Eisa, Adam Cuker, Carolyn E Beck, Rachael F Grace, Justin W Yan and 31 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Emily SirotichMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Saifur R ChowdhuryMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-4361-0792
Dimpy ModiMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-5879-4179
Gordon GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Melanie St JohnMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Kerolos EisaMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Adam CukerDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.ORCID 0000-0002-3595-5697
Carolyn E BeckDivision of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Rachael F GraceDepartment of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA.ORCID 0000-0001-7302-0449
Justin W YanDivision of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Shuoyan NingMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Charles T QuinnDepartment of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Amanda PfeifferDepartment of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Michele P LambertDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.ORCID 0000-0003-0439-402X
Karen PanckeriDepartment of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA.
Allyson PishkoDepartment of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA.
Kristine VanAarsenDivision of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID 0000-0002-8189-1831
Ahmed SlimDepartment of Emergency Medicine, London Health Sciences Centre, London, ON, Canada.
Kathryn CarrierDivision of Hematology/Oncology, Boston Children's Hospital, Boston, MA.
Rebecca GeerDepartment of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Abinaya ArulselvanDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.
Matthew BasaraDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.
Brenna CannonDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.
Ellis J BloomDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.
Sam J KingDivision of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA.ORCID 0009-0007-4522-4680
Daya GillMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Laura M VenierMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-0009-7418
Emily XuMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Ishaq SiddiquiMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Bonnie LiuMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Timothy MercierDepartment of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA.
Taylah BuisserethDepartment of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA.
Emily M HarrisDepartment of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA.ORCID 0000-0001-8583-6939
Enass H RaffaDepartment of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.ORCID 0000-0002-3625-2416
Joel LivingstonPediatric Hematology/KidClot, Department of Paediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0003-3528-4456
Mahmudur Rahman ChowdhuryDepartment of Public Health, North South University, Dhaka, Bangladesh.
Maryam Akbari-MoghaddamMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Dongyoung KimMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Dena ZeraatkarDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Donald M ArnoldMichael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-0943-8853

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractCritical bleeding in patients with immune thrombocytopenia (ITP) is a life-threatening hematologic emergency. This study aimed to describe the frequency, management, and outcomes of critical bleeds among adults and children with ITP. We conducted a retrospective cohort study of patients with ITP who presented to the emergency room with a platelet count <20 × 109/L across 7 centers in the United States and Canada between 2010 and 2019. Of 1226 patients (n = 296 adults; n = 930 children), 28 (2.3%) had critical bleeds (adults, n = 15 [median age, 68 years]; children, n = 13 [median age, 11 years]). Of patients with critical bleeds, 12 adults (80.0%) and 6 children (46.2%) had intracranial hemorrhage (ICH). For adults, the common interventions used to treat critical bleeds were platelet transfusions (n = 11 [73.3%]), corticosteroids (n = 10 [66.7%]), and IV immunoglobulin (n = 8 [53.3%]), and for children, common interventions were IV immunoglobulin (n = 10 [76.9%]), corticosteroids (n = 8 [61.5%]), platelet transfusions (n = 8 [61.5%]), thrombopoietin receptor agonists (n = 4 [30.8%]), and antifibrinolytic agents (n = 4 [30.8%]). For both adults and children, the most common treatment combination was corticosteroids, IV immunoglobulin, and platelet transfusion (n = 6 [40.0%] vs n = 6 [46.2%]). The median time from presentation to first treatment was 6.9 hours for adults and 3.5 hours for children. Overall, 9 patients (32.1%) with critical ITP bleeds died, including 7 adults (46.7%) and 2 children (15.4%). Critical bleeding in patients with ITP was rare but frequently fatal, especially among older adults with ICH and when treatments were delayed.

Indexed as

HemorrhagePurpura, Thrombocytopenic, IdiopathicAdolescentAdultAgedAged, 80 and overCanadaChildChild, PreschoolDisease ManagementFemaleHumansImmunoglobulins, IntravenousMaleMiddle AgedRetrospective StudiesImmunoglobulins, Intravenous

Identifiers

PMID40203187
PMCPMC12246609

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.