Abstract W P235: Predictors of Platelet Transfusion in Patients with Intracerebral Hemorrhage

Background and Objectives: Data on the impact of platelet transfusions (PTx) on outcomes after intracerebral hemorrhage (ICH) are conflicting. Current guidelines state that PTx in ICH patients with a history of antiplatelet (AP) use is considered investigational. We examined the use of PTx in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study hypothesizing that PTx use would be highly variable and influenced by the need for surgery. Methods: ERICH is a prospective observational case-control study designed to find risk factors for ICH among whites, blacks, and Hispanics. We used a backward-elimination logistic regression of baseline demographic and clinical data to compare those who did and did not receive PTx. We examined patterns of PTx across ERICH centers grouped by location. Results: As of 1/1/2013, 19 centers enrolled 1341 cases of ICH of whom 10% (138) received PTx. Multivariable logistic regression demonstrated that race was not a predictor of PTx, but older age (OR 1.02), AP use (OR 4.47), thrombocytopenia (OR 14.37), hematoma evacuation (OR 3.25), and history of stroke (OR 1.68) were significantly associated with use of PTx. Roughly 27% (37/138) of patients who received PTx were not on an antiplatelet agent or had platelet counts >100K. Overall, 23% of patients with ICH on AP received PTx, but it varied from 0%-74% among the ERICH centers (Fig). Six centers administered PTx to <10% of patients and 3 centers administered PTx in ≥ 50% of patients. Conclusion: We need further studies to determine if any patient population should receive PTx and to develop greater consistency regarding the use of PTx in the ICH population.