The thrombotic microangiopathies (TTP and HUS) can cause morbidity and mortality. Peigne et al identified risk factors for mortality in these patients. The authors are from Hopital Saint-Louis in Paris.
Patient selection: age > 18 years with thrombotic microangiopathy (TMA)
Outcome: death within 180 days (6 months) but median time was 7 days (5 to 14 days)
Risk factors for mortality from the multivariate analysis:
(1) cardiac involvement at diagnosis (any indication of myocardial ischemia including elevated troponin level, arrhythmia, cardiogenic shock)
(2) failure to use plasma exchange therapy (plasma exchange therapy protective)
Additional findings associated with mortality:
(1) SAPS 2 score > 40 at presentation
(2) failure to treat with corticosteroids
(3) severe nosocomial infection
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