Abnormal platelet count is an independent predictor of mortality in the elderly and is influenced by ethnicity

Pavlos Msaouel, Anthony P. Lam, Krishna Gundabolu, Grigorios Chrysofakis, Yiting Yu, Ioannis Mantzaris, Ellen Friedman, Amit K. Verma

Research output: Contribution to journalArticle

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Abstract

Even though alterations in platelet counts are presumed to be detrimental, their impact on the survival of patients has not been studied in large cohorts. The prevalence of thrombocytopenia and thrombocytosis was examined in a large inner city outpatient population of 36,262 individuals aged =65 years old. A significant association with shorter overall survival was found for both thrombocytopenia (HR=1.45; 95% CI: 1.36-1.56) and thrombocytosis (HR=1.75; 95% CI: 1.56-1.97) when compared to the survival of patients with normal platelet counts. This effect persisted across all ethnic groups. However, African-Americans (non-Hispanic Blacks) with either thrombocytopenia or thrombocytosis were at significantly lower risk compared to non-Hispanic Caucasians (HR=0.82; 95% CI: 0.69-0.96 and HR=0.70; 95% CI: 0.53-0.94, respectively). Furthermore, Hispanics with thrombocytosis were found to have a lower mortality risk compared to non-Hispanic Caucasians with thrombocytosis (HR=0.60; 95% CI: 0.44-0.81). A value of <125,000 platelets per microliter was a better prognostic marker for non-Hispanic Blacks and these subjects with this platelet count had similar overall survival to that of Caucasians with a value of <150,000 per microliter. In conclusion, thrombocytosis and thrombocytopenia are independently associated with shorter overall survival in elderly subjects and this effect is modified by ethnicity. Using different thresholds to define the association of thrombocytopenia and thrombocytosis with overall mortality risk among non-Hispanic Blacks may, therefore, be warranted.

Original languageEnglish (US)
Pages (from-to)930-936
Number of pages7
JournalHaematologica
Volume99
Issue number5
DOIs
StatePublished - May 1 2014

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Thrombocytosis
Platelet Count
Thrombocytopenia
Mortality
Survival
Hispanic Americans
Ethnic Groups
African Americans
Outpatients
Blood Platelets
Population

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

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Abnormal platelet count is an independent predictor of mortality in the elderly and is influenced by ethnicity. / Msaouel, Pavlos; Lam, Anthony P.; Gundabolu, Krishna; Chrysofakis, Grigorios; Yu, Yiting; Mantzaris, Ioannis; Friedman, Ellen; Verma, Amit K.

In: Haematologica, Vol. 99, No. 5, 01.05.2014, p. 930-936.

Research output: Contribution to journalArticle

Msaouel, Pavlos ; Lam, Anthony P. ; Gundabolu, Krishna ; Chrysofakis, Grigorios ; Yu, Yiting ; Mantzaris, Ioannis ; Friedman, Ellen ; Verma, Amit K. / Abnormal platelet count is an independent predictor of mortality in the elderly and is influenced by ethnicity. In: Haematologica. 2014 ; Vol. 99, No. 5. pp. 930-936.
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abstract = "Even though alterations in platelet counts are presumed to be detrimental, their impact on the survival of patients has not been studied in large cohorts. The prevalence of thrombocytopenia and thrombocytosis was examined in a large inner city outpatient population of 36,262 individuals aged =65 years old. A significant association with shorter overall survival was found for both thrombocytopenia (HR=1.45; 95{\%} CI: 1.36-1.56) and thrombocytosis (HR=1.75; 95{\%} CI: 1.56-1.97) when compared to the survival of patients with normal platelet counts. This effect persisted across all ethnic groups. However, African-Americans (non-Hispanic Blacks) with either thrombocytopenia or thrombocytosis were at significantly lower risk compared to non-Hispanic Caucasians (HR=0.82; 95{\%} CI: 0.69-0.96 and HR=0.70; 95{\%} CI: 0.53-0.94, respectively). Furthermore, Hispanics with thrombocytosis were found to have a lower mortality risk compared to non-Hispanic Caucasians with thrombocytosis (HR=0.60; 95{\%} CI: 0.44-0.81). A value of <125,000 platelets per microliter was a better prognostic marker for non-Hispanic Blacks and these subjects with this platelet count had similar overall survival to that of Caucasians with a value of <150,000 per microliter. In conclusion, thrombocytosis and thrombocytopenia are independently associated with shorter overall survival in elderly subjects and this effect is modified by ethnicity. Using different thresholds to define the association of thrombocytopenia and thrombocytosis with overall mortality risk among non-Hispanic Blacks may, therefore, be warranted.",
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