Evans Syndrome: Analysis of 1255 Adult Cases in US Hospitals, Revealing Demographics, Associations, and Outcomes

Rushin  Patel; Mrunal  Patel; Fehmida  Laxmidhar; Darshil  Patel; Zalak  Patel; Safia  Shaikh; Khushboo  Lakhatariya

doi:10.18502/ijhoscr.v19i2.18546

Rushin Patel Department of Internal Medicine, Community Hospital of San Bernardino, CA, USA
Mrunal Patel Department of Internal Medicine, Trumbull Regional Medical Center, OH, USA
Fehmida Laxmidhar Department of Internal Medicine, Trumbull Regional Medical Center, OH, USA
Darshil Patel Clinical Research Program, Rush University, IL, USA
Zalak Patel Department of Internal Medicine, University of California Riverside, CA, USA
Safia Shaikh Department of Internal Medicine, Washington University, MO, USA
Khushboo Lakhatariya Department of Internal Medicine, Trumbull Regional Medical Center, OH, USA

DOI: https://doi.org/10.18502/ijhoscr.v19i2.18546

Keywords: Evans Syndrome; Immune thrombocytopenia; Autoimmune hemolytic anemia; Autoimmune neutropenia; Demographics; Associations

Abstract

Background: Evans syndrome (ES) is a rare immune disorder characterized by immune thrombocytopenia and warm autoimmune hemolytic anemia (wAIHA), with the possibility of autoimmune neutropenia (AIN). Limited data due to its rarity led us to perform a descriptive analysis of demographics, outcomes, and comorbidities.

Materials and Methods: This study used the National Inpatient Sample database to identify Evans syndrome hospitalizations (ICD-10 code D69.41) from 2016 to 2019, with national estimates. We collected demographic data, examined outcomes, and assessed patient comorbidity. STATA Version 17 was used for data analysis.

Results: In our study of 1,255 ES hospitalizations, the mean age was 50.13 years, with a relatively even gender distribution. The racial breakdown included White (59.6%), Black (17.1%), and Hispanic (14.6%). Most had Medicare (41.8%), Medicaid (20.4%), or private insurance (33.5%). Charlson Comorbidity Index scores varied, with 36.6% scoring 3 or more. Non-elective admissions accounted for 90.2% of cases, coming from various U.S. Census Divisions, with East North Central (16.2%) and Pacific (16.1%) leading. Large urban teaching hospitals handled 84.1% of cases. Mortality was 5.5%, the mean stay was 7.8 days, with total charges averaging $114,696. Notable associations included SLE (15.63%), ITP (37%), and anemia (53.5%). Inpatient risks included AKI (22.47%) and sepsis (15.33%). Interventions included red blood cell transfusion (18.65%) and platelet transfusion (10.44%).

Conclusion: This study offers key insights into ES in hospitalized adults, emphasizing demographic trends and important associations with other conditions. More research is required to enhance our understanding of ES and enhance outcomes for those affected.