Prospective Evaluation Of ITP Bleeding Scale Of Version 2016 In The Application Of Primary Immune Thrombocytopenia

BackgroundPrimary immune thrombocytopenia(ITP)is an acquired auto-immune bleeding disease.Many bleeding grading systems have been used internationally to assess bleeding risk,however,none of them were applied widely.In 2013,International Work Group put forward ITP specific bleeding assessment tool(ITP-BAT),which has become the recognized tool for quantifying bleeding.But its long time-consuming for collecting data weakened the clinical practicality.To simplify assessment procedure and enhance practicality,consensus of Chinese experts on diagnosis and treatment of adult primary immune thrombocytopenia(version 2016)issued by Chinese Medical Association recommend ITP bleeding sacale(version 2016 of ITP bleeding scale).ObjectiveTo evaluate the clinical significance of ITP bleeding scale(version2016)prospectively.Methods88 patients were assessed by ITP bleeding scale(version 2016)and ITP-BAT to analyze the association between bleeding score of ITP bleeding scale(version 2016)and platelet counts,gender,disease stage,also to evaluate interinstrument consistency between two bleeding grading systems.Among 47 new-diagnosed ITP patients treated with high dose dexamethasone,bleeding score of ITP bleeding scale(version 2016)and platelet counts were assessed before treatment,one week and two weeks after treatment,respectively,to evaluate the responsiveness of ITP bleeding scale(version 2016).ResultsBleeding score of ITP patients was negatively correlated with platelet counts(r=-0.515,P<0.001).Gender and disease stage had no significant influence on bleeding score(F=4.255,P=0.382;F=5.251,P=0.753).ITP bleeding scale was in excellent agreement with ITP-BAT.Change of bleeding score of 47 ITP patients before and after high dose dexamethasone treatment had significant difference(z=-5.612,P<0.001),also,the same result was observed in patients who didn’t get complete response(z=-3.969,P<0.001).Back-to-back scoring consistency of two doctors was 94.4%(k=0.918).It took less time to accomplish ITP bleeding scale(version 2016)than ITP-BAT[3(2-6)min vs 7(4-13)min,z=-8.213,P<0.001].ConclusionsITP bleeding scale(version 2016)has good responsiveness,strong assessment consistency,close correlation with ITP-BAT and less time-consuming in clinical application.It can be used as an effective tool of condition judgement,risk assessment and efficacy evaluation of ITP patients.