Descriptive analysis of included patients
The general information of the included patients was shown in Figure 1. Generally, the included patients were older; the average age of all patients reached 61.94 years. The youngest patient was 26 years old, and the oldest patient was 79 years old. As shown in Figure 1 above, Of the selected 179 male patients and 54 female patients, Also, 100 patients had thrombocytopenia of grade II, accounting for 42.9%; 94 patients had thrombocytopenia of grade III, accounting for 40.3%; 39 patients had thrombocytopenia of grade IV, accounting for 16.7%. Ninety-two patients were undergoing concurrent radiotherapy or chemotherapy during the rhTPO treatment of thrombocytopenia, which accounted for 39.5%. Besides, 123 patients postponed the next cycle of chemotherapy or radiotherapy due to platelet decline, accounting for 52.8%; 28 patients changed the treatment plan for malignant tumors due to severe platelet decline, accounting for 12.0%; 36 patients reduced the dose of chemotherapy drugs due to thrombocytopenia, accounting for 15.5%; 55 patients had platelet transfusions during this period, accounting for 23.6%.
The ages of patients and the days of rhTPO treatment were counted. After rhTPO treatment, the day when platelet count started to increase was counted. Meanwhile, the postponed days of chemotherapy, the length of extended hospital stay, and the increased costs of hospitalization due to platelet decline were counted. The initial therapy of patients was shown in Table 1.
Patients included were generally older, with an average age of 61.94 years old; the youngest patient was 26 years old, and the oldest patient was 79 years old. The standard deviation of the rhTPO treatment days of patients was huge. Personal differences might cause this. The median of rhTPO treatment days was 5; the average value was 5.99, indicating that the treatment duration of some patients was longer. The most prolonged treatment duration reached 40 days. Due to personal differences of patients, the day when platelet count started to increase was different. Some patients began to have increased platelet levels on the 1st day of rhTPO treatment, while some patients showed improved platelet levels after 21 days of rhTPO treatment. The postponed days of the next chemotherapy cycle reached 91, consistent with the length of extended hospital stay due to platelet decline. As indicated in the increased hospitalization costs due to platelet decline, the increases in hospitalization costs due to the platelet decline were tremendous; the possible reason was that patients suffering from malignant tumors require not only the treatment of thrombocytopenia but also the monitoring of other physical conditions.
Comparison of rhTPO usage between patients with different degree of thrombocytopenia
The comparison of rhTPO usage between patients with different degree of thrombocytopenia and the information of radiotherapy/chemotherapy were shown in Table 2.
The differences in “days of rhTPO treatment,” “the day when platelet count started to increase,” “postponed days of the next cycle of chemotherapy,” “length of extended hospital stay due to platelet decline,” “increased hospitalization costs due to platelet decline,” and “with or without platelet transfusion” of patients with different thrombocytopenia grades were statistically significant. Also, the difference in “with or without concurrent radiotherapy/chemotherapy” of the three thrombocytopenia degrees was statistically significant (P <0.05). In patients with grade II thrombocytopenia, those who received concurrent radiotherapy/chemotherapy accounted for 32%. In patients with grade III thrombocytopenia, those who received concurrent radiotherapy/chemotherapy accounted for 48.9%. In patients with grade IV thrombocytopenia, those who received concurrent radiotherapy/chemotherapy accounted for 35.9%. Therefore, the difference in “with or without concurrent radiotherapy/chemotherapy” of patients with grade II and grade III thrombocytopenia was huge. Then, the pairwise analyses of χ2 values and P values were performed.
The difference in concurrent radiotherapy/chemotherapy of patients with grade II and grade III thrombocytopenia was statistically significant (P <0.05), that of patients with grade II and IV thrombocytopenia was not statistically significant (P >0.05), and that of patients with grade IV and III thrombocytopenia was also not statistically significant (P >0.05). These results were with the results presented in Table 3.
Pairwise analyses obtained the statistical data between the two groups, as shown in Table 3 and Table 4.
In Tables 3 and 4, the difference in each variable between patients with grade II and IV thrombocytopenia was statistically significant (P <0.05). Between patients with grade III and grade IV thrombocytopenia, only the variable “with or without platelet transfusion” had a statistically significant difference (P <0.05). Besides, the difference in each variable between patients with grade II and III thrombocytopenia was statistically significant (P <0.05).
Economic analysis results
After statistics, the expenses of all patients were obtained. The results were shown in Figure 2. The medical expenses of patients during the extended hospital stay due to platelet decline increased dramatically, in which the expenses on rhTPO occupied the majority. Besides, during the same period, the expenses on other drugs were the same as those on rhTPO, indicating that the medication of patients during this period was dominated by rhTPO. However, in severe cases, some patients required platelet transfusion. Therefore, extra expenses on platelet transfusion were generated. The above figure also suggested that patients with IV thrombocytopenia had the most platelet transfusion, resulting in increased costs during treatment; as the degree of thrombocytopenia increased, the cost of treatment also increased.
The length of extended hospital stays and the increased cost of hospitalization due to platelet decline were described. As the platelet decreased, the length of hospital stays and the costs of hospitalization would increase. Therefore, thrombocytopenia would bring more significant economic burdens on patients.